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External-beam radiotherapy and androgen-deprivation therapy (ADT) for 6 months to 3 years lengthen disease-free and overall survival in patients with locally advanced prostate cancer. Use of ADT as primary therapy for patients with nonmetastatic prostate cancer has increased significantly during the past decade, as has recognition of therapy-related toxicity, including risk for heart disease and development of the metabolic syndrome. These ADT-related risks are greater in older men and can persist after discontinuation of therapy.
To evaluate further the relation of ADT, preexisting coronary artery disease (CAD), and fatal myocardial infarction (MI), a group of international investigators evaluated data from three prospective randomized tria…