Evidence map›Paper›PMID 39237679›Full record

SynthesisProstate cancer and prostatic diseases2025

Cardiovascular events among men with prostate cancer treated with androgen receptor signaling inhibitors: a systematic review, meta-analysis, and network meta-analysis.

Akihiro Matsukawa, Takafumi Yanagisawa, Mehdi Kardoust Parizi, Ekaterina Laukhtina, Jakob Klemm, Tamás Fazekas, Keiichiro Mori, Shoji Kimura, Alberto Briganti, Guillaume Ploussard and 5 more

Erratum issuedAbstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  6. The burden of cardiovascular disease in prostate cancer: prevalence, pathophysiology, and implications for integrated care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Akihiro MatsukawaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-3324-762X
Takafumi YanagisawaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-7410-0712
Mehdi Kardoust PariziDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Ekaterina LaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-8953-0272
Jakob KlemmDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Tamás FazekasDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Keiichiro MoriDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Shoji KimuraDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Alberto BrigantiUnit of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Guillaume PloussardDepartment of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France.
Pierre I KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
Jun MikiDepartment of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Takahiro KimuraDepartment of Urology, The Jikei University School of Medicine, Tokyo, Japan.ORCID http://orcid.org/0000-0002-5673-1553
Pawel RajwaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0003-4073-6584
Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at.ORCID http://orcid.org/0000-0002-6627-6179

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAndrogen-receptor pathway inhibitors (ARPIs) have dramatically changed the management of advanced/metastatic prostate cancer (PCa). However, their cardiovascular toxicity remains to be clarified.

objectiveTo analyze and compare the risks of cardiovascular events secondary to treatment of PCa patients with different ARPIs.

methodsIn August 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled studies (RCTs) that analyze PCa patients treated with abiraterone, apalutamide, darolutamide, and enzalutamide. The primary outcomes of interest were the incidence of cardiac disorder, heart failure, ischemic heart disease (IHD), atrial fibrillation (AF), and hypertension. Network meta-analyses (NMAs) were conducted to compare the differential outcomes of each ARPI plus androgen deprivation therapy (ADT) compared to standard of care (SOC).

resultsOverall, 26 RCTs were included. ARPIs were associated with an increased risk of cardiac disorders (RR: 1.74, 95% CI: 1.13-2.68, p = 0.01), heart failure (RR: 2.49, 95% CI: 1.05-5.91, p = 0.04), AF (RR: 2.15, 95% CI: 1.14-4.07, p = 0.02), and hypertension (RR: 2.06, 95% CI: 1.67-2.54, p < 0.01) at grade ≥3. Based on NMAs, abiraterone increased the risk of grade ≥3 cardiac disorder (RR:2.40, 95% CI: 1.42-4.06) and hypertension (RR:2.19, 95% CI: 1.77-2.70). Enzalutamide was associated with the increase of grade ≥3 AF(RR: 3.17, 95% CI: 1.05-9.58) and hypertension (RR:2.30, 95% CI: 1.82-2.92).

conclusionsThe addition of ARPIs to ADT increases the risk of cardiac disorders, including IHD and AF, as well as hypertension. Each ARPI exhibits a distinct cardiovascular event profile. Selecting patients carefully and vigilant monitoring for cardiovascular issues is imperative for those undergoing ARPI + ADT treatment.

Indexed as

Androgen Receptor AntagonistsCardiovascular DiseasesProstatic NeoplasmsAndrostenesBenzamidesHumansMaleNitrilesPhenylthiohydantoinRandomized Controlled Trials as TopicabirateroneAndrogen Receptor AntagonistsAndrostenesBenzamidesenzalutamideNitrilesPhenylthiohydantoin

Identifiers

PMID39237679
PMCPMC12106084

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.