Androgen‐suppression therapy for prostate cancer and the risk of death in men with a history of myocardial infarction or stroke

Study Type – Prognosis (inception cohort) Level of Evidence 1b OBJECTIVE To examine the effect of short‐course androgen‐suppression therapy (AST) before brachytherapy on all‐cause mortality (ACM) rates, stratified by the presence or absence of a history of myocardial infarction (MI) or stroke. AST is used to reduce prostate size to enable men with favourable‐risk prostate cancer to undergo brachytherapy, but no disease‐specific benefit has been reported for this practice, and AST use has been associated with an increased risk of ACM in some men with pre‐existing cardiovascular disease. PATIENTS AND METHODS The study comprised 12 792 men with favourable‐risk disease, i.e. a prostate‐specific antigen (PSA) level of