Impact of Medical Castration on Malignant Arrhythmias in Patients With Prostate Cancer

    February 2021 in “ Journal of the American Heart Association ”
    Kanae Hasegawa, Hiroki Ito, Kenichi Kaseno, Shinsuke Miyazaki, Yuichiro Shiomi, Naoto Takahashi, Hiroyuki Ikeda, Kentaro Ishida, Hiroyasu Uzui, Seiko Ohno, Minoru Horie, Osamu Yokoyama, Hiroshi Tada
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    Studysummary This study observed that medical castration for prostate cancer prolongs the QT/QTc intervals, potentially leading to serious arrhythmias like torsade de pointes and ventricular fibrillation, even in patients without prior QT prolongation risk. Our plain-language summary of this paper — not a Tressless recommendation.
    The study "Impact of Medical Castration on Malignant Arrhythmias in Patients With Prostate Cancer" involved 149 patients and found that medical castration, using gonadotropin-releasing hormones with/without antiandrogen, prolonged the QT and corrected QT (QTc) intervals in 79.9% of patients. This could lead to torsade de pointes (TdP) and ventricular fibrillation (VF), even in patients with no prior risk of QT prolongation. TdP/VF occurred in 1.3% of patients, typically 6 months or more after starting medical castration. An increase in the QTc interval from the pretreatment value >50 ms might predict TdP/VF. The study concluded that monitoring the QTc interval, especially the change in QTc interval (ΔQTc), is crucial throughout medical castration to prevent malignant arrhythmias.
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