Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population-based propensity score matching study

Bum Sik Tae, Byeong Jo Jeon, Hoon Choi, Jae Hyun Bae, Jae Young Park

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2 Citations (Scopus)

Abstract

PURPOSE: Previous studies have suggested that androgen deprivation therapy (ADT) is associated with cerebral infarction. However, conflicting results have been reported by other researchers. The aim of this study was to evaluate the association between ADT and cerebral infarction in patients with prostate cancer (PC) using big data. MATERIALS AND METHODS: Using information from the National Health Insurance Service database representative of the entire Korean adult PC population (n = 206 735), data regarding ADT and cerebral infarction between 2009 and 2016 were analyzed. Adjusted hazard ratios for cerebral infarction associated with ADT were estimated using propensity score-matched Cox proportional hazards models and Kaplan-Meier survival analyses. RESULTS: The final cohort comprised 36 146 individuals with PC, including 24 069 men (66.6%) who underwent ADT. During the mean follow-up of 4.1 years, 2792 patients were newly diagnosed with cerebral infarction. In the unmatched cohort, there was a significant difference in the annual incidence of cerebral infarction between the ADT and non-ADT groups (22.8 vs 14.6 per 1000 person-years, respectively). However, there was no significant difference between the ADT and non-ADT groups in the matched cohort (14.9 vs 14.6 per 1000 person-years). The adjusted hazard ratio for cerebral infarction for PC patients who underwent ADT was 1.045 (95% CI 0.943-1.159; P = 0.401) compared with those who did not undergo ADT. In addition, the cumulative duration of ADT was also not associated with an increased risk for cerebral infarction. However, older age, hypertension, diabetes, myocardial infarction, congestive heart failure, peripheral vascular disease, renal disease, dementia, and atrial fibrillation were revealed to be factors contributing to cerebral infarction. CONCLUSION: This nationwide population-based study revealed that ADT was not associated with cerebral infarction after adjusting for potential confounders.

Original languageEnglish
Pages (from-to)4475-4483
Number of pages9
JournalCancer medicine
Volume8
Issue number9
DOIs
Publication statusPublished - 2019 Aug 1

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Propensity Score
Cerebral Infarction
Androgens
Prostatic Neoplasms
Population
Therapeutics
National Health Programs
Group Psychotherapy
Peripheral Vascular Diseases
Kaplan-Meier Estimate
Survival Analysis
Proportional Hazards Models
Atrial Fibrillation
Dementia
Research Design
Heart Failure
Myocardial Infarction
Research Personnel
Databases

Keywords

  • androgen deprivation therapy
  • cerebral infarction
  • nationwide population-based study
  • prostate neoplasm

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

@article{f744d2b4f590441f9710a7900868482a,
title = "Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population-based propensity score matching study",
abstract = "PURPOSE: Previous studies have suggested that androgen deprivation therapy (ADT) is associated with cerebral infarction. However, conflicting results have been reported by other researchers. The aim of this study was to evaluate the association between ADT and cerebral infarction in patients with prostate cancer (PC) using big data. MATERIALS AND METHODS: Using information from the National Health Insurance Service database representative of the entire Korean adult PC population (n = 206 735), data regarding ADT and cerebral infarction between 2009 and 2016 were analyzed. Adjusted hazard ratios for cerebral infarction associated with ADT were estimated using propensity score-matched Cox proportional hazards models and Kaplan-Meier survival analyses. RESULTS: The final cohort comprised 36 146 individuals with PC, including 24 069 men (66.6{\%}) who underwent ADT. During the mean follow-up of 4.1 years, 2792 patients were newly diagnosed with cerebral infarction. In the unmatched cohort, there was a significant difference in the annual incidence of cerebral infarction between the ADT and non-ADT groups (22.8 vs 14.6 per 1000 person-years, respectively). However, there was no significant difference between the ADT and non-ADT groups in the matched cohort (14.9 vs 14.6 per 1000 person-years). The adjusted hazard ratio for cerebral infarction for PC patients who underwent ADT was 1.045 (95{\%} CI 0.943-1.159; P = 0.401) compared with those who did not undergo ADT. In addition, the cumulative duration of ADT was also not associated with an increased risk for cerebral infarction. However, older age, hypertension, diabetes, myocardial infarction, congestive heart failure, peripheral vascular disease, renal disease, dementia, and atrial fibrillation were revealed to be factors contributing to cerebral infarction. CONCLUSION: This nationwide population-based study revealed that ADT was not associated with cerebral infarction after adjusting for potential confounders.",
keywords = "androgen deprivation therapy, cerebral infarction, nationwide population-based study, prostate neoplasm",
author = "Tae, {Bum Sik} and Jeon, {Byeong Jo} and Hoon Choi and Bae, {Jae Hyun} and Park, {Jae Young}",
year = "2019",
month = "8",
day = "1",
doi = "10.1002/cam4.2325",
language = "English",
volume = "8",
pages = "4475--4483",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
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TY - JOUR

T1 - Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population-based propensity score matching study

AU - Tae, Bum Sik

AU - Jeon, Byeong Jo

AU - Choi, Hoon

AU - Bae, Jae Hyun

AU - Park, Jae Young

PY - 2019/8/1

Y1 - 2019/8/1

N2 - PURPOSE: Previous studies have suggested that androgen deprivation therapy (ADT) is associated with cerebral infarction. However, conflicting results have been reported by other researchers. The aim of this study was to evaluate the association between ADT and cerebral infarction in patients with prostate cancer (PC) using big data. MATERIALS AND METHODS: Using information from the National Health Insurance Service database representative of the entire Korean adult PC population (n = 206 735), data regarding ADT and cerebral infarction between 2009 and 2016 were analyzed. Adjusted hazard ratios for cerebral infarction associated with ADT were estimated using propensity score-matched Cox proportional hazards models and Kaplan-Meier survival analyses. RESULTS: The final cohort comprised 36 146 individuals with PC, including 24 069 men (66.6%) who underwent ADT. During the mean follow-up of 4.1 years, 2792 patients were newly diagnosed with cerebral infarction. In the unmatched cohort, there was a significant difference in the annual incidence of cerebral infarction between the ADT and non-ADT groups (22.8 vs 14.6 per 1000 person-years, respectively). However, there was no significant difference between the ADT and non-ADT groups in the matched cohort (14.9 vs 14.6 per 1000 person-years). The adjusted hazard ratio for cerebral infarction for PC patients who underwent ADT was 1.045 (95% CI 0.943-1.159; P = 0.401) compared with those who did not undergo ADT. In addition, the cumulative duration of ADT was also not associated with an increased risk for cerebral infarction. However, older age, hypertension, diabetes, myocardial infarction, congestive heart failure, peripheral vascular disease, renal disease, dementia, and atrial fibrillation were revealed to be factors contributing to cerebral infarction. CONCLUSION: This nationwide population-based study revealed that ADT was not associated with cerebral infarction after adjusting for potential confounders.

AB - PURPOSE: Previous studies have suggested that androgen deprivation therapy (ADT) is associated with cerebral infarction. However, conflicting results have been reported by other researchers. The aim of this study was to evaluate the association between ADT and cerebral infarction in patients with prostate cancer (PC) using big data. MATERIALS AND METHODS: Using information from the National Health Insurance Service database representative of the entire Korean adult PC population (n = 206 735), data regarding ADT and cerebral infarction between 2009 and 2016 were analyzed. Adjusted hazard ratios for cerebral infarction associated with ADT were estimated using propensity score-matched Cox proportional hazards models and Kaplan-Meier survival analyses. RESULTS: The final cohort comprised 36 146 individuals with PC, including 24 069 men (66.6%) who underwent ADT. During the mean follow-up of 4.1 years, 2792 patients were newly diagnosed with cerebral infarction. In the unmatched cohort, there was a significant difference in the annual incidence of cerebral infarction between the ADT and non-ADT groups (22.8 vs 14.6 per 1000 person-years, respectively). However, there was no significant difference between the ADT and non-ADT groups in the matched cohort (14.9 vs 14.6 per 1000 person-years). The adjusted hazard ratio for cerebral infarction for PC patients who underwent ADT was 1.045 (95% CI 0.943-1.159; P = 0.401) compared with those who did not undergo ADT. In addition, the cumulative duration of ADT was also not associated with an increased risk for cerebral infarction. However, older age, hypertension, diabetes, myocardial infarction, congestive heart failure, peripheral vascular disease, renal disease, dementia, and atrial fibrillation were revealed to be factors contributing to cerebral infarction. CONCLUSION: This nationwide population-based study revealed that ADT was not associated with cerebral infarction after adjusting for potential confounders.

KW - androgen deprivation therapy

KW - cerebral infarction

KW - nationwide population-based study

KW - prostate neoplasm

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