Cardio-oncology & otherRandomised controlled trial

Specialist Referral for Cardiovascular Risk in Patients With Prostate Cancer

JAMA Intern MedPublished

  • randomized clinical trial
  • 55 sites in 8 countries
  • 1:1 allocation

Authors' conclusion

In this randomized clinical trial, routine referral of patients with prostate cancer to a cardiovascular specialist lead to improved outcomes, specifically through better cholesterol control. However, it is uncertain whether this reduced clinical cardiovascular events.

Study context

Population
Patients diagnosed with prostate cancer during the past 12 months who had received androgen deprivation therapy (ADT) for the first time within the past 6 months or planned to start ADT in the next month; patients taking a statin with a systolic blood pressure of 130 mm Hg or lower were ineligiblepatients with prostate cancer included in the analysis (mean [SD] age, 68 [8] years)
Participants
2,487 patients
Comparison
intervention group vs control group
Primary endpoint
Hierarchical composite of:
  • Cardiovascular death
  • Myocardial infarction
  • Stroke
  • Heart failure
  • Suboptimal cholesterol (total cholesterol, >155 mg/dL)
  • Suboptimal blood pressure (systolic blood pressure, >130 mm Hg) as evaluated by the win ratio
Follow-up
Median (IQR) 5.8 (2.7-8.2) years

Primary result

As reported in the abstract

Win ratio

1.60

95% CI 1.42–1.81

intervention group vs control group
win ratio 1.60 (95% CI 1.42–1.81)

Further findings

Outcomemean difference (mg/dL) (95% CI)
Cholesterol · lower cholesterol in the intervention group12 (9–15)

Close-out systolic blood pressure

Outcomesubdistribution hazard ratio (95% CI)
Time to cardiovascular death, myocardial infarction, stroke, or heart failure · no difference between groups1.08 (0.79–1.49)

Original publication

Specialist Referral for Cardiovascular Risk in Patients With Prostate Cancer. JAMA Intern Med. Published 30 August 2026. doi:10.1001/jamainternmed.2026.4773

Summarised from the published abstract; every number is checked against it