Have we mis-PRONOUNCEd the cardiovascular risk of GnRH agonists? A critical appraisal of the PRONOUNCE trial

2022 ◽  
Author(s):  
Raj Tiwari ◽  
Katherine Lajkosz ◽  
Neil Fleshner ◽  
Christopher J. D. Wallis
Keyword(s):  
Cardiovascular Risk ◽  
Critical Appraisal ◽  
Gnrh Agonists

scholarly journals Assessment and Mitigation of Cardiovascular Risk for Prostate Cancer Patients: A review of the evidence

2021 ◽  
Author(s):  
Patrick Davey ◽  
Kyriacos Alexandrou
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cancer Patients ◽  
Molecular Mechanisms ◽  
Risk Mitigation ◽  
Current Evidence ◽  
Gnrh Agonists ◽  
Gnrh Antagonists ◽  
Co Morbidity

Abstract Background: Cardiovascular disease (CVD) is a common co-morbidity in patients with prostate cancer. In this review, we summarise the published literature on the association of cardiovascular risk with androgen deprivation therapy (ADT) treatment and explore the potential differences between the gonadotropin-releasing hormone (GnRH) agonists and antagonists and the molecular mechanisms that may be involved. We also provide a practical outlook on the identification of underlying CV risk and explore the different stratification tools available. Results: While not definitive, the current evidence suggests that GnRH antagonists may be associated with lower rates of certain CV events vs agonists, particularly in patients with pre-existing CVD. We have reached this conclusion as the highest-grade evidence from randomised clinical trials comparing GnRH agonists verses antagonists is uniform in finding lower CV event rates with GnRH antagonists. Risk reduction strategies such as lifestyle advice, consideration of ADT modality, and co-medications may help to reduce CV risk factors and improve outcomes in prostate cancer patients receiving ADT. Conclusions: Given all the data that is currently available, identification of baseline CV risk factors may be key to risk mitigation in patients with prostate cancer receiving ADT.

scholarly journals CETP inhibition in cardiovascular risk management: a critical appraisal

2007 ◽  
Vol 37 (2) ◽  
pp. 90-98 ◽  
Author(s):  
R. P. F. Dullaart ◽  
G. M. Dallinga-Thie ◽  
B. H. R. Wolffenbuttel ◽  
A. van Tol
Keyword(s):  
Risk Management ◽  
Cardiovascular Risk ◽  
Critical Appraisal ◽  
Cardiovascular Risk Management ◽  
Cetp Inhibition

scholarly journals Cardiovascular Risk Profile in Prostate Cancer Patients Treated with GnRH Agonists versus Antagonists: An Italian Real-World Analysis

2020 ◽  
Vol Volume 16 ◽  
pp. 393-401 ◽  
Author(s):  
Valentina Perrone ◽  
Luca Degli Esposti ◽  
Elisa Giacomini ◽  
Chiara Veronesi ◽  
Valerio Blini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cardiovascular Risk ◽  
Cancer Patients ◽  
Real World ◽  
Risk Profile ◽  
Gnrh Agonists ◽  
Cardiovascular Risk Profile
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