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However, their cardiovascular toxicity remains to be clarified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze and compare the risks of cardiovascular events secondary to treatment of PCa patients with different ARPIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In August 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled studies (RCTs) that analyze PCa patients treated with abiraterone, apalutamide, darolutamide, and enzalutamide. The primary outcomes of interest were the incidence of cardiac disorder, heart failure, ischemic heart disease (IHD), atrial fibrillation (AF), and hypertension. Network meta-analyses (NMAs) were conducted to compare the differential outcomes of each ARPI plus androgen deprivation therapy (ADT) compared to standard of care (SOC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 26 RCTs were included. ARPIs were associated with an increased risk of cardiac disorders (RR: 1.74, 95% CI: 1.13\u20132.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), heart failure (RR: 2.49, 95% CI: 1.05\u20135.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), AF (RR: 2.15, 95% CI: 1.14\u20134.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and hypertension (RR: 2.06, 95% CI: 1.67\u20132.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) at grade \u22653. Based on NMAs, abiraterone increased the risk of grade \u22653 cardiac disorder (RR:2.40, 95% CI: 1.42\u20134.06) and hypertension (RR:2.19, 95% CI: 1.77\u20132.70). Enzalutamide was associated with the increase of grade \u22653 AF(RR: 3.17, 95% CI: 1.05\u20139.58) and hypertension (RR:2.30, 95% CI: 1.82\u20132.92).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of ARPIs to ADT increases the risk of cardiac disorders, including IHD and AF, as well as hypertension. Each ARPI exhibits a distinct cardiovascular event profile. Selecting patients carefully and vigilant monitoring for cardiovascular issues is imperative for those undergoing ARPI\u2009+\u2009ADT treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-024-00886-0","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T03:03:08Z","timestamp":1725505388000},"page":"298-308","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Cardiovascular events among men with prostate cancer treated with androgen receptor signaling inhibitors: a systematic review, meta-analysis, and network meta-analysis"],"prefix":"10.1038","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-762X","authenticated-orcid":false,"given":"Akihiro","family":"Matsukawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-0712","authenticated-orcid":false,"given":"Takafumi","family":"Yanagisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi Kardoust","family":"Parizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-0272","authenticated-orcid":false,"given":"Ekaterina","family":"Laukhtina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Klemm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"Fazekas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichiro","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Ploussard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre I.","family":"Karakiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Miki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5673-1553","authenticated-orcid":false,"given":"Takahiro","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4073-6584","authenticated-orcid":false,"given":"Pawel","family":"Rajwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-6179","authenticated-orcid":false,"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"886_CR1","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.eururo.2022.08.002","volume":"82","author":"T Yanagisawa","year":"2022","unstructured":"Yanagisawa T, Rajwa P, Thibault C, Gandaglia G, Mori K, Kawada T, et al. 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