2036P - Prevalence and risk evaluation of cardiovascular disease among newly diagnosed prostate cancer population in China

Background

Cardiovascular disease (CVD) emerged as a leading death cause in prostate cancer (PC) patients in recent decades, bringing great disease burden globally. Men with preexisting CVD were at increased risk for major adverse cardiovascular events when treated with ADT. The prevalence and risk evaluation of CVD among the newly diagnosed PC population in China has remained a blank.

Methods

Clinical data of newly diagnosed PC patients was retrospectively collected from 34 centers in China. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-risk, middle-risk and high-risk.

Results

A total of 4135 patients was enrolled in the present study, and 26.97% complained a current or history of CVD. The enrolled population distributed in 6 regions of China and about 70% patients lived in urban settings. With imaging and pathological evaluation, most of PC patients were diagnosed at late stage, with 20.80% local progression and 20.80% metastasis. Most of them initiated prostatectomy (46.48%) or regimens involving ADT therapy (45.83%) for prostate cancer. In the present PC cohort, 43.36% were hypertension patients and 50.81% of them lived with poor control of blood pressure. In patients with comorbid PC and CVD, 27.80% had two or more CVDs. With FRS stratification, as expected, higher risk of CVD was related with aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an original higher risk of CVD than those without. That was in accordance with the clinical practice, i.e., aged patients or patients at late oncological stage were inclined to accept systematic integrative therapy, instead of surgery. Among patients accepting medical castration, only 4.37% received GnRH antagonist in stark contrast to the grim situation of CVD prevalence and risk.

Conclusions

Prostate cancer patients in China are diagnosed at a later stage. Heavy CVD burden was presented at the initiation of treatment. Patients accepting ADT-related therapy occupied an original higher risk of CVD but the consciousness of cardiovascular protection was far from sufficient.

Clinical trial identification

Editorial acknowledgement

We thank centers providing clinical data for the present study, they are Sun Yat-sen University Cancer Center, Second Xiangya Hospital affiliated to Central South University, Yangjiang People's Hospital, Wuhan Tongji Hospital, Shandong Provincial Cancer Hospital, Shandong Provincial Hospital, Affiliated Hospital of Qingdao University, The Third Affiliated Hospital of Southern Medical University, Liaoyang Fifth People's Hospital, Jiangsu Provincial People's Hospital, Henan Provincial Cancer Hospital, Xinghe Hospital in Hebei Province, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Red Cross Hospital, Nanjing Gulou Hospital, Union Hospital Affiliated to Fujian Medical University.

Legal entity responsible for the study

Peking University People's Hospital.

Funding

Pfizer.

Disclosure

All authors have declared no conflicts of interest.