Prostate cancer is prevalent among men, and Androgen Deprivation Therapy (ADT) remains a cornerstone in managing advanced stages of this disease. However, ADT has been associated with cardiovascular side effects, raising concerns, especially in populations with a high baseline risk for cardiovascular diseases. This study aims to investigate the impact of ADT on cardiac function over a short-term follow-up in prostate cancer patients. Specifically, it evaluates changes in echocardiography measures (GLS%, LVEF), electrocardiographic parameters, myocardial injury markers, and lipid profiles in patients undergoing different ADT regimens.

This prospective observational study was conducted at the Department of Urology, Apollo Hospital, Chennai, India over a 24-month period from December 2022 to January 2025. Seventy prostate cancer patients (mean age 68.1 ± 8.4 years) who required ADT were recruited and classified into treatment groups receiving Degarelix (GnRH antagonist), Leuprolide and Goserelin (GnRH agonist), or bilateral orchiectomy. Echocardiographic evaluations (GLS%, LVEF%), blood investigations (Hs Trop-I, NT Pro-BNP), ECG monitoring, and lipid profile assessments were conducted pre-treatment (M1) and at three months post-therapy (M2). Statistical analysis, including paired t-tests and Wilcoxon sign-rank tests, was applied to determine significant changes, with p < 0.05 considered statistically significant.

Echocardiographic analysis demonstrated a statistically significant reduction in LVEF% (63.2 ± 3.3 to 61.3 ± 4.0, p < 0.001) and GLS% (16.4 ± 2.4 to 15.1 ± 2.3, p < 0.001) after three months of ADT. Additionally, significant ECG findings included QRS (98.9 ± 21.4 to 103.2 ± 24.3 ms, p = 0.016) and QTc prolongation (413.6 ± 40.8 to 425.7 ± 47.2 ms, p = 0.017). Myocardial injury markers showed notable increases: Hs Trop-I from 4.9 ± 6.3 to 8.1 ± 14.4 ng/mL (p < 0.001) and NT Pro-BNP from 238.8 ± 404.8 to 365.3 ± 647.7 pg/mL (p < 0.001). The lipid profile analysis indicated elevated total cholesterol (161.8 ± 42.7 to 175.7 ± 38.9 mg/dL, p = 0.008), triglycerides (140.6 ± 60.9 to 153.9 ± 75.1 mg/dL, p = 0.044), and HDL (41.4 ± 11.1 to 43.8 ± 10.6 mg/dL, p = 0.013). There was no statistically significant change in SBP, DBP, or serum electrolyte levels.

This study confirms that ADT in prostate cancer patients is associated with early cardiovascular changes, including reduced cardiac function (GLS%, LVEF), ECG changes (QRS, QTc), and elevated myocardial injury markers (Hs Trop-I, NT Pro-BNP), within the first three months of therapy. These findings underscore the need for cardiac evaluation before and during ADT treatment in prostate cancer patients, particularly for those with preexisting cardiovascular risk factors. Further longitudinal studies with larger sample sizes are warranted to substantiate these findings and to guide clinical monitoring protocols.