SynthesisInternational urology and nephrology2026
Impact of androgen deprivation therapy and androgen receptor pathway inhibitors on cardiac structure and function evaluated by echocardiography in males with prostate cancer: a systematic review and meta-analysis.
Synthesis in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAndrogen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) are cornerstones in the treatment of prostate cancer (PC), but are associated with adverse cardiovascular effects. The objective of this work was to systematically review and analyse cardiac structure and function in PC patients undergoing therapy with ADT or ARPIs as assessed with echocardiography.
methodsThe work was pre-registered with Prospero (CRD42024539717). We searched PubMed/Medline, Ovid/Embase, Cochrane Library, and Google Scholar on January 7th, 2025. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 were followed. Studies with PC patients treated with ADT or ARPI, compared to baseline, and assessed with echocardiography were included. Quality was assessed using the Newcastle-Ottawa Scale and Risk of Bias 2. Mean differences in echocardiographic measurements during treatment compared to baseline were assessed in meta-analyses.
resultsSix studies (three prospective cohort studies, one retrospective cohort study, and two randomised trials) with 560 patients all examining the influence of ADT on echocardiographic parameters were included in the meta-analysis, which showed a reduction in left ventricular (LV) ejection fraction (- 2.32%, 95% CI [- 3.82, - 0.82], p = 0.0025, I
conclusionsPC patients undergoing ADT may experience reduced LV systolic function compared to baseline, indicative of cardiomechanical deterioration due to ADT. Important limitations include possible publication bias and heterogeneity in included studies, which highlight the need for larger studies.
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