RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad and Andrea KokorovicCardiometabolic side effects of androgen deprivation therapy in prostate cancerLafontaine, Marie-Lyssa; Kokorovic, Andrea Author Information Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada Correspondence to Andrea Kokorovic, DrUniversity of Montreal Hospital Center (CHUM), 1000 rue Saint-Denis - B.06.8022, Montréal, QC H2X 0C1, Canada. E-mail: [email protected] Current Opinion in Supportive and Palliative Care: December 2022 - Volume 16 - Issue 4 - p 216-222 doi: 10.1097/SPC.0000000000000624 Buy Metrics Abstract Purpose of review Androgen-deprivation therapy (ADT) is widely employed for treatment of advanced prostate cancer and it is considered the frontline therapy. However, the numerous adverse reactions associated with this treatment option are concerning and its potential association with cardiovascular diseases (CVD) should not be overlooked. In this review, we examine the literature on the cardiovascular side effects of ADT and the physiologic mechanisms underpinning the association with CVD. We will also specifically discuss the different findings regarding the interesting potential disparity in major cardiovascular events among GnRH agonist-treated patients compared with patients undergoing GnRH antagonist treatment. Recent findings Androgen-deprivation therapy increases the risk of developing CVD by altering the body composition, metabolism, vascular system, and cardiac physiology. GnRH agonists may pose a higher risk of cardiovascular mortality and morbidity than GnRH antagonists; however, this link remains to be determined. Furthermore, screening for cardiovascular risk factors before and during ADT treatment is a crucial step in preventing major adverse cardiac events in prostate cancer patients. Notably, preexisting CVD and comorbidities have been identified as major key elements predicting cardiovascular events. Early implementation of pharmacological and nonpharmacological treatment strategies is strongly suggested, and regular follow-up visits should be scheduled to continuously assess patients’ cardiovascular risk under ADT. Summary ADT is a very powerful treatment option for advanced prostate cancer that improves survival outcomes but has the potential of considerably impacting patients’ cardiovascular health. Medical optimization and close monitoring are crucial during treatment with ADT. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.