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Prostate cancer patients on hormone therapy at increased risk for various heart diseases
Date:9/22/2009

he risk of a fatal heart attack was increased by 28%, the risk of dying from heart disease by 21%, the risk of heart failure death was increased by 26% and the risk of fatal arrhythmia was increased by 5%.

"In a more detailed analysis by type of hormone therapy, the lowest increase in risk for ischaemic heart disease, heart attack and heart failure was seen in the group taking anti-androgen therapy, and we saw no increase in risk of death from heart disease in this group," Ms Van Hemelrijck said. "Patients on gonadotropin releasing hormone agonist therapy had the highest risk of these problems."

For instance, the increased heart failure risk for anti-androgens was 5%, compared with 34% for gonadotropin releasing hormone agonists and the increased ischaemic heart disease risk was 13% in the anti-androgen group, compared with 30% in the gonadotropin releasing hormone agonist therapy group.

"The finding that anti-androgens carry the least heart risk supports the view that circulating testosterone may protect the heart," she said.

The association with heart risk when the testicles were removed was close to that seen with the gonadotropin releasing hormone agonist therapy, Ms Van Hemelrijck added.

The increased risk of heart events requiring hospitalisation was less pronounced in patients who already had heart disease before hormone treatment, with a 17% risk increase for a new ischaemic heart disease event among those with a history of heart disease, compared with a 41% increase among men who didn't have any heart trouble before hormone treatment, for instance. Ms Van Hemelrijck said that could be because the men who already had heart disease were likely to be taking heart medications that protected them from further heart risk imposed by the endocrine treatment.

"We now need studies verifying the association and exploring plausible biological mechanisms. Then we would know how to best use these treatments accor
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Contact: Emma Ross
rosswrite@mac.com
ECCO-the European CanCer Organisation
Source:Eurekalert

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