Background: Given the potential cardiovascular risks of androgen deprivation therapy (ADT), it is essential to identify patients who may be at an increased risk for coronary artery disease (CAD). Despite the recent ESC recommendations, there is no consensus on when to refer a patient to a cardiologist for further evaluation. Objective: To report on new diagnoses of CAD in patients with prostate cancer (PCa) requiring ADT who underwent a systematic cardio-onco evaluation with an assessment of their coronary status. Design, Setting, and Participants: This is a retrospective, monocentric study that included patients with PCa who had completed a cardio-onco evaluation with an assessment of their coronary status in the cardio-oncology department at the Western Cancer Institute, Nantes, between January 2019 and August 2022. Intervention: The baseline cardio-onco evaluation included a physical exam, transthoracic echography, and electrocardiogram, followed with a systematic evaluation of their coronary status. Outcome Measurements and Statistical Analysis: The primary objective was to determine the incidence of newly diagnosed CAD. The secondary objective was to evaluate the number of changes in cardiovascular treatment. Results and Limitations: Among the 34 patients who underwent cardio-onco evaluation, 7 (20.6%) were diagnosed with CAD, with a median time to diagnosis of 5 months. Most patients were asymptomatic, with one who experienced a myocardial infarction. Of the 27 patients without CAD, 44.4% underwent a therapeutic intervention by the cardiologist, with no cardiac deaths during follow-up. Overall, 55.9% of patients had a therapeutic intervention after the cardio-onco evaluation. Conclusions: The high incidence of newly diagnosed CAD in asymptomatic patients supports the need for screening for CAD in this population. Further research is needed to determine whether routine screening for CAD in patients receiving ADT would result in significant clinical benefits.
背景：鉴于雄激素剥夺疗法（ADT）潜在的心血管风险，识别冠状动脉疾病（CAD）风险升高的患者至关重要。尽管近期欧洲心脏病学会（ESC）发布了相关建议，但对于何时应将患者转诊至心脏科进行进一步评估，目前尚未达成共识。 目的：报告接受ADT治疗的前列腺癌（PCa）患者在接受系统性心脏肿瘤学评估并检查冠状动脉状况后新诊断出的CAD病例。 设计、设置与参与者：这是一项回顾性单中心研究，纳入2019年1月至2022年8月期间在南特西部癌症研究所心脏肿瘤科完成心脏肿瘤学评估及冠状动脉状况检查的PCa患者。 干预措施：基线心脏肿瘤学评估包括体格检查、经胸超声心动图和心电图，随后系统性地评估其冠状动脉状况。 结果测量与统计分析：主要目标是确定新诊断CAD的发生率。次要目标是评估心血管治疗方案变更的数量。 结果与局限性：在接受心脏肿瘤学评估的34例患者中，7例（20.6%）被诊断为CAD，诊断中位时间为5个月。大多数患者无症状，其中1例发生心肌梗死。在27例未患CAD的患者中，44.4%接受了心脏科医生的治疗干预，随访期间无心脏性死亡。总体而言，55.9%的患者在心脏肿瘤学评估后接受了治疗干预。 结论：无症状患者中新诊断CAD的高发生率支持在该人群中进行CAD筛查的必要性。需要进一步研究以确定对接受ADT治疗的患者进行常规CAD筛查是否能带来显著的临床获益。
肿瘤(癌症)患者之家