Antiandrogenic therapy can cause coronary arterial disease

Int J Urol. 2005 Oct;12(10):886-91. doi: 10.1111/j.1442-2042.2005.01145.x.


Aim: To study the change of lipid metabolism by antiandrogen therapy in patients with prostate cancer.

Materials and methods: We studied with a 2.5 years follow-up the changes in plasma cholesterols (C), triglycerides (TG), lipoproteins (LP), and apolipoproteins (Apo) B-100, A-I, and A-II pro fi les in 24 patients of mean age 60 years with low risk prostate cancer (stage: T1cN0M0, Gleason score: 2-5) during treatment with cyproterone acetate (CPA) without surgical management or radiation therapy.

Results: Significant decreases of HDL-C, Apo A-I and Apo A-II and an increase of triglyceride levels in VLDL were induced by CPA. After a period of 2.5 years on CPA treatment, four patients out of twenty-four were found to be affected by coronary heart disease.

Conclusions: Ischaemic coronary arteriosclerosis with an incidence rate of 16.6% as caused by prolonged CPA therapy is mediated through changes in HDL cholesterol, Apo A-I and Apo A-II pro fi les, other than the well-known hyperglyceridemic effect caused by estrogen.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Androgen Antagonists / adverse effects*
  • Androgen Antagonists / therapeutic use
  • Apolipoprotein A-I / blood
  • Apolipoprotein A-II / blood
  • Biomarkers / blood
  • Cholesterol, HDL / blood
  • Coronary Disease / blood
  • Coronary Disease / chemically induced*
  • Coronary Disease / physiopathology
  • Cyproterone Acetate / adverse effects*
  • Cyproterone Acetate / therapeutic use
  • Electrocardiography
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / drug therapy*
  • Risk Factors
  • Triglycerides / blood


  • Androgen Antagonists
  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Biomarkers
  • Cholesterol, HDL
  • Triglycerides
  • Cyproterone Acetate