Specialist Referral for Cardiovascular Risk in Patients With Prostate Cancer: A Randomized Clinical Trial
Primary result · Hierarchical composite of cardiovascular death, myocardial infarction, stroke, heart failure, suboptimal cholesterol (total cholesterol, >155 mg/dL) and suboptimal blood pressure (systolic blood pressure, >130 mm Hg) as evaluated by the win ratioResult — go to the resultWin ratio 1.60 95% CI 1.42–1.81Authors' 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
Methodological details55 sites in 8 countries, 1:1 allocation
- 55 sites in 8 countries
- 1:1 allocation
Primary result
As reported in the abstract
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
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
| Outcome | Mean difference (mg/dL) (95% CI) | |
|---|---|---|
| Cholesterol · lower cholesterol in the intervention group | 12 (9–15) | |
| −1001020Difference, mg/dL (linear scale) |
Close-out systolic blood pressure
| Outcome | Subdistribution hazard ratio (95% CI) | |
|---|---|---|
| Time to cardiovascular death, myocardial infarction, stroke, or heart failure · no difference between groups | 1.08 (0.79–1.49) | |
| 0.512Subdistribution hazard ratio (log scale) |
Original publication
Specialist Referral for Cardiovascular Risk in Patients With Prostate Cancer: A Randomized Clinical Trial. JAMA Intern Med. Published 30 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it