#1151

Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer Patients: A Prospective Study

R. Narasimhan¹, M. Tiwari², N. Penchala reddy²

¹Apollo hospitals, Urology, India
²Apollo hospitals, Urology, Chennai, India

Introduction:

Prostate cancer is prevalent among men, and Androgen Deprivation Therapy (ADT) remains a cornerstone in managing advanced stages of this disease. However, ADT has been associated with cardiovascular side effects, raising concerns, especially in populations with a high baseline risk for cardiovascular diseases. This study aims to investigate the impact of ADT on cardiac function over a short-term follow-up in prostate cancer patients. Specifically, it evaluates changes in echocardiography measures (GLS%, LVEF), electrocardiographic parameters, myocardial injury markers, and lipid profiles in patients undergoing different ADT regimens.

Material and methods:

This prospective observational study was conducted at the Department of Urology, Apollo Hospital, Chennai, India over a 24-month period from December 2022 to January 2025. Seventy prostate cancer patients (mean age 68.1 ± 8.4 years) who required ADT were recruited and classified into treatment groups receiving Degarelix (GnRH antagonist), Leuprolide and Goserelin (GnRH agonist), or bilateral orchiectomy. Echocardiographic evaluations (GLS%, LVEF%), blood investigations (Hs Trop-I, NT Pro-BNP), ECG monitoring, and lipid profile assessments were conducted pre-treatment (M1) and at three months post-therapy (M2). Statistical analysis, including paired t-tests and Wilcoxon sign-rank tests, was applied to determine significant changes, with p < 0.05 considered statistically significant.

Results:

Echocardiographic analysis demonstrated a statistically significant reduction in LVEF% (63.2 ± 3.3 to 61.3 ± 4.0, p < 0.001) and GLS% (16.4 ± 2.4 to 15.1 ± 2.3, p < 0.001) after three months of ADT. Additionally, significant ECG findings included QRS (98.9 ± 21.4 to 103.2 ± 24.3 ms, p = 0.016) and QTc prolongation (413.6 ± 40.8 to 425.7 ± 47.2 ms, p = 0.017). Myocardial injury markers showed notable increases: Hs Trop-I from 4.9 ± 6.3 to 8.1 ± 14.4 ng/mL (p < 0.001) and NT Pro-BNP from 238.8 ± 404.8 to 365.3 ± 647.7 pg/mL (p < 0.001). The lipid profile analysis indicated elevated total cholesterol (161.8 ± 42.7 to 175.7 ± 38.9 mg/dL, p = 0.008), triglycerides (140.6 ± 60.9 to 153.9 ± 75.1 mg/dL, p = 0.044), and HDL (41.4 ± 11.1 to 43.8 ± 10.6 mg/dL, p = 0.013). There was no statistically significant change in SBP, DBP, or serum electrolyte levels.