| Objective: Many studies have shown an increase morbidity and mortality of cardiovascular diseases(CVDs)in prostate cancer(PC)patients treated with endocrine therapy(ET),but baseline data on CVDs before the initiation of ET in these patients are scarce.The aim of this study is to investigate the distribution of CVDs and related risk factors in PC patients before ET.Methods: In this study,a total of 1745 patients who were admitted to the First Affiliated Hospital of Dalian Medical University from May 31,2008 to July 1,2021,and were initially diagnosed with PC after surgery or pathological biopsy,and who had not received any ET and had potential ET indications were included.Excluding patients with severe liver and kidney insufficiency,mental illness,immune system disease,severe infection or multiple organ failure,who were not suitable for ET,or patients with other types of tumors,vital value deletion,receiving any type of ET or antitumor therapy,severe dyslipidemia,familial inheritance,etc.After the inclusion and exclusion criteria,a total of 870 patients with PC were enrolled in this study.Baseline data(age,blood lipid,blood glucose,uric acid,creatinine,blood pressure,smoking history,drinking history,etc),CVD history and related risk factors of all patients were collected.Results: A total of 870 patients with PC were included in the study,with an average age of 73.9±9.7 years old and the majority between 65 and 85 years old.These patients had already had serious CVD burden before starting ET,and 46.0% were complicated with at least one kind of CVDs.Hypertension(HTN)(37.9%)is the most common CVD comorbidities in PC patients,followed by coronary heart disease(CHD)(20.5%),stroke(15.6%),heart failure(HF)(5.3%)and atrial fibrillation(AF)(4.9%).The blood pressure classification of HTN patients with cancer was mainly grade I(52.4%)and grade II(35.8%),but the cardiovascular risk stratification of these patients was mainly high risk(22.4%)and very high risk(73.2%).Among all HTN patients,198(63.3%)reached the blood pressure standard.In HTN patients who did not reach the target range,the higher the cardiovascular risk level,the worse the blood pressure control.Patients with HTN had higher prevalence of AF,HF,CHD and stroke than those without HTN,and the difference was statistically significant.In terms of risk factors related to CVD,the prevalence rate of dyslipidemia was significant,accounting for 652 patients(74.9%).Among them,dyslipidemia was most common with high-density lipoprotein(HDL-C)decline.The proportion of other risk factors was 19.7%,11.7%,and 17%,respectively,for smoking,drinking and diabetes.A 10-year risk assessment of coronary atherosclerotic heart disease(ASCVD)was conducted among the included patients.All patients were at risk of ASCVD,and only 330(36.0%)of them used lipid-lowering drugs,indicating a low use rate of lipid-lowering drugs.Among them,373(42.9%)were at low risk,166(19.1%)were at medium risk,153(17.6%)were at high risk and 178(20.4%)were at very high risk.The utilization rate of lipid-lowering drugs at each risk level was 23.3%,28.9%,41.2% and 74.2%,respectively.The rates of low-density lipoprotein(LDL-C)reaching the standard were 87.9%,62.0%,21.6% and 2.2%,respectively.Conclusion: Before ET in patients with PC,many patients had serious burden of CVDs.The HTN was the most common type,very high risk was the most common in cardiovascular risk classification,the higher blood pressure grade was,the more poorly blood pressure controlled.Patients with HTN had higher risk of other CVDs.More than half of the patients with PC had dyslipidemia,mainly HDL-C reduction.The utilization rate of lipid-lowering drugs was low,and the rate of lipid compliance gradually decreased with the increased risk of ASCVD.These patients had low utilization rate of lipid-lowering drugs and poor blood lipid control.The blood lipids and blood pressure of these patients were also not well controlled,and the risk of CVDs is high.This suggests that the risk of CVDs should be carefully assessed before ET for such patients,and multidisciplinary collaborative management should be performed. |
