Enfermedad cardiovascular asociada a las terapias supresoras de andrógenos utilizadas para el tratamiento del cáncer de próstata: una revisión de alcance





Cardiotoxicity; Androgen; Prostate cancer.


Worldwide, prostate cancer (PCa) represents the second leading cause of death from cancer in the male population, and shares many of the risk factors that also predispose to the emergence of cardiovascular diseases (CVD's). The established treatment for PCa involves the use of androgen deprivation therapies, although this strategy is known to induce myocardial injury. The purpose of this text is to discuss the association between CVDs and androgen suppression therapies used for PCa. For this Scope Review, carried out through the PubMed and Science Direct platforms between 2020 and 2022, the descriptors chosen were ''Heart'', ''Therapy'', ''Androgen'' and ''Prostate Cancer'', associated with the boolean operator ''AND''. Inclusion criteria consisted of 1) clinical trials, controlled and randomized trials, reviews and meta-analyses; 2) studies on the association between CVDs and androgen suppression therapies 3) studies that evaluated the damage caused by cardiotoxicity, as well as its management and follow-up and 4) articles in English, Spanish and Portuguese. Exclusion criteria consisted of inadequacies to the topic, case reports and studies with animals, in addition to texts outside the time limit. It was observed that the use of androgen deprivation for PCa can induce adverse cardiovascular repercussions, such as systemic arterial hypertension, heart failure, acute myocardial infarction and stroke. Discontinuation of these drugs and consensus on the threshold of toxicity for these drugs are still controversial topics, as is the choice of cardioprotective therapies.


Asensio, A. A., Ossorio, J. A., Olmo, J. C., Abal, V. C., Soto, A. J., Espinos, E. L., & Vilaseca, A. (2022). Non-metastatic castration-resistant prostate cancer: management recommendations. Actas Urol Esp. (English Edition).

Bigaran, A., Zopf, E., Gardner, J., La Gerche, A., Murphy, D. G., Howden, E. J., & Cormie, P. (2021). The effect of exercise training on cardiometabolic health in men with prostate cancer receiving androgen deprivation therapy: A systematic review and meta-analysis. Prostate Cancer Prostatic Dis., 24(1), 35-48.

Cereda, V., Falbo, P. T., Manna, G., Iannace, A., Menghi, A., Corona, M., & Lanzetta, G. (2020). Hormonal prostate cancer therapies and cardiovascular disease: a systematic review. Heart Fail. Rev., 1-16.

Challa, A. A., Calaway, A. C., Cullen, J., Garcia, J., Desai, N., Weintraub, N. L., & Guha, A. (2021). Cardiovascular toxicities of androgen deprivation therapy. Curr Treat Options Oncol., 22(6), 1-20.

Davey, P., & Alexandrou, K. (2021). Assessment and mitigation of cardiovascular risk for prostate cancer patients: a review of the evidence. Int. J. Clin. Pract., 2022.

Gheorghe, G. S., Hodorogea, A. S., Ciobanu, A., Nanea, I. T., & Gheorghe, A. C. D. (2021). Androgen deprivation therapy, hypogonadism and cardiovascular toxicity in men with advanced prostate cancer. Curr Oncol., 28(5), 3331-3346.

Hajjar, L. A., Costa, I. B. S. D. S. D., Lopes, M. A. C. Q., Hoff, P. M. G., Diz, M. D. P. E., Fonseca, S. M. R., & Kalil Filho, R. (2020). Diretriz Brasileira de Cardio-oncologia–2020. Arq. Bras. Cardiol., 115, 1006-1043.

Higano, C. S. (2020, December). Update on cardiovascular and metabolic risk profiles of hormonal agents used in managing advanced prostate cancer. Urol. Oncol. (38(12), 912-917). Elsevier.

Hu, J., Aprikian, A. G., Vanhuyse, M., & Dragomir, A. (2022). Comparative cardiovascular safety of novel hormonal agents in metastatic castration-resistant prostate cancer using real-world data. Clin. Genitourin. Cancer, 20(1), 17-24.

INCA. (2019). Tipos de câncer. Portal eletrônico do INCA. https://www.inca.gov.br/tipos-de-cancer/cancer-de-prostata/profissional-de-saude

Joshi, S. N., Murphy, E. A., Olaniyi, P., & Bryant, R. J. (2021). The multiple effects of aspirin in prostate cancer patients. Cancer Treat. Res., 26, 100267.

Kenk, M., Grégoire, J. C., Coté, M. A., Connelly, K. A., Davis, M. K., Dresser, G., & Fleshner, N. (2020). Optimizing screening and management of cardiovascular health in prostate cancer: A review. Can. Urol. Assoc. J., 14(9), E458.

Kim, D. K., Lee, H. S., Park, J. Y., Kim, J. W., Hah, Y. S., Ha, J. S., & Cho, K. S. (2022, January). Risk of cardiovascular intervention after androgen deprivation therapy in prostate cancer patients with a prior history of ischemic cardiovascular and cerebrovascular disease: A nationwide population-based cohort study. Urol. Oncol.: Semin. Orig. Investig. (Vol. 40, No. 1, pp. 6-e11). Elsevier

Kulkarni, A. A., Rubin, N., Tholkes, A., Shah, S., Ryan, C. J., Lutsey, P. L., & Rao, A. (2021). Risk for stroke and myocardial infarction with abiraterone versus enzalutamide in metastatic prostate cancer patients. ESMO open, 6(5), 100261.

Langley, R. E., Gilbert, D. C., Duong, T., Clarke, N. W., Nankivell, M., Rosen, S. D., & Parmar, M. (2021). Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme. Lancet., 397(10274), 581-591.

Lifshitz, K., Ber, Y., Shenhar, C., Nillson, J., Peer, A., Rosenbaum, E., & Margel, D. (2021). Cardiovascular proteomics: A post hoc analysis from a phase II randomized clinical trial comparing GnRH antagonist vs GnRH agonist among men with advanced prostate cancer. J. Urol., 206(4), 952-959.

Lopez, D. S., Kim, H., Polychronopoulou, E., Taha, S., Tsilidis, K. K., Villasante-Tezanos, A., & Canfield, S. (2022). Joint association of statins and testosterone replacement therapy with cardiovascular disease among older men with prostate cancer: SEER-Medicare 2007–2015. Cancer Epidemiol., 79, 102172

Lu-Yao, G., Nikita, N., Keith, S. W., Nightingale, G., Gandhi, K., Hegarty, S. E., & Kelly, W. K. (2020). Mortality and hospitalization risk following oral androgen signaling inhibitors among men with advanced prostate cancer by pre-existing cardiovascular comorbidities. Eur. Urol., 77(2), 158-166.

Margel, D., Ber, Y., Peer, A., Shavit-Grievink, L., Pinthus, J. H., Witberg, G., & Rosenbaum, E. (2021). Cardiac biomarkers in patients with prostate cancer and cardiovascular disease receiving gonadotrophin releasing hormone agonist vs antagonist. Prostate Cancer Prostatic Dis., 24(1), 177-185.

Melloni, C., & Roe, M. T. (2020, February). Androgen deprivation therapy and cardiovascular disease. Urol. Oncol.: Semin. Orig. Investig. (38(2), 45-52). Elsevier.

Melloni, C., Slovin, S. F., Blemings, A., Goodman, S. G., Evans, C. P., Nilsson, J., & PRONOUNCE Investigators. (2020). Cardiovascular safety of degarelix versus leuprolide for advanced prostate cancer: the PRONOUNCE trial study design. Cardio-oncology, 2(1), 70-81.

Morgans, A. K., Shore, N., Cope, D., McNatty, A., Moslehi, J., Gomella, L., & Sartor, O. (2021, January). Androgen receptor inhibitor treatments: Cardiovascular adverse events and comorbidity considerations in patients with non-metastatic prostate cancer. Urol. Oncol.: Semin. Orig. Investig. (39(1), 52-62). Elsevier

Muniyan, S., Xi, L., Datta, K., Das, A., Teply, B. A., Batra, S. K., & Kukreja, R. C. (2020). Cardiovascular risks and toxicity-The Achilles heel of androgen deprivation therapy in prostate cancer patients. Biochim Biophys Acta Rev Cancer., 1874(1), 188383.

Queiroz, L. D. F. R., de Negreiros, R. V., Pereira, A. M., Luna, A. C. R., Menezes, G. R. S., de Medeiros Pereira, M. A., & Porto, R. F. (2022). Morbimortalidade por câncer de próstata nas regiões brasileiras no período de 2016 a 2020. RSD, 11(3), e26511326293-e26511326293.

Vinh-Hung, V., Natchagande, G., Joachim, C., Gorobets, O., Drame, M., Bougas, S., & Yin, M. (2020). Low-dose enzalutamide in late-elderly patients (≥ 75 years old) presenting with metastatic castration-resistant prostate cancer. Clin. Genitourin. Cancer, 18(6), e660-e668.



How to Cite

SANTOS, T. L. .; LIMA, C. S. de A. .; SOUZA, G. L. e .; OLIVEIRA, M. F. de .; BELINATI, K. D. .; PINZON, A. P. A. .; PAVONI, B. de C. .; DRUMMOND JÚNIOR, D. G. .; GUEDES, I. H. L. .; FOLONI, B. V. . Enfermedad cardiovascular asociada a las terapias supresoras de andrógenos utilizadas para el tratamiento del cáncer de próstata: una revisión de alcance. Research, Society and Development, [S. l.], v. 11, n. 11, p. e162111133570, 2022. DOI: 10.33448/rsd-v11i11.33570. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/33570. Acesso em: 28 sep. 2022.



Review Article