Cardio-oncology & otherCohort study
Social Determinants of Health Mediate Racial Disparities in Cardiovascular Disease in Men With Prostate Cancer
- Retrospective cohort study
- quaternary, multisite health care system
- mediation analysis
Authors' conclusion
Black patients are significantly more likely to experience adverse CVD outcomes after systemic ADT compared with their White counterparts. These disparities are mediated by socioeconomic status and other structural determinants of health as captured by census tract SVI.
Study context
- Population
- Men with prostate cancer treated with systemic androgen deprivation therapy (ADT), 2008–2021
- Participants
- 3,543 men
- Exposure
- Black vs White race
- Outcome
- Incident MACE after ADT initiation
Main finding
MACE
Hazard ratio
1.38
95% CI 1.16–1.65
P < 0.001
Black vs White
HR 1.38 (95% CI 1.16–1.65); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Incident HF, cerebrovascular disease, PAD — Black vs White · HF | 1.79 (1.32–2.43) | P < 0.001 | |
| Incident HF, cerebrovascular disease, PAD — Black vs White · cerebrovascular disease | 1.98 (1.37–2.87) | P < 0.001 | |
| Incident HF, cerebrovascular disease, PAD — Black vs White · PAD | 1.76 (1.26–2.45) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Mediation of major adverse cardiovascular events (MACE) disparity by social vulnerability index (SVI)
- SVI, specifically the socioeconomic status theme, mediated the disparity in MACE risk between Black and White patients
- 98%
Original publication
Social Determinants of Health Mediate Racial Disparities in Cardiovascular Disease in Men With Prostate Cancer. JACC CardioOncol. Published 18 June 2024. doi:10.1016/j.jaccao.2024.04.004
Summarised from the published abstract; every number is checked against it