Coronary Plaque Progression After Androgen Deprivation Therapy in Men With Prostate Cancer: A Randomized Clinical Trial - PubMed

4 days ago

Androgen deprivation therapy (ADT) for prostate cancer (PCa) is linked to cardiovascular (CV) morbidity, but the biological basis is unclear.
The study compared coronary plaque progression between GnRH agonist (leuprolide) and antagonist (relugolix) in men with nonmetastatic PCa undergoing pelvic radiotherapy.
Primary outcome: Change in coronary artery total plaque volume (TPV) after 12 months of ADT.
Secondary outcomes: Changes in noncalcified plaque volume (NCPV), calcified plaque volume (CPV), and low-attenuation plaque volume (LAPV).
Results: Leuprolide showed significantly greater increases in TPV and NCPV compared to relugolix, suggesting higher CV risk with GnRH agonists.
No significant differences were observed in CPV or LAPV between the two treatments.
Conclusion: GnRH agonist leuprolide is associated with greater coronary plaque progression, driven by noncalcified plaque, potentially explaining ADT-associated CV risk.

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