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Background: Androgen deprivation therapy (ADT) in the treatment of prostate cancer may be associated with an increased risk of thromboembolic disease. The aim of our study was to investigate the association of ADT in the treatment of prostate cancer with ischemic stroke risk., Methods: We identified individuals older than 20 years of age who were newly diagnosed with prostate cancer between January 1, 2005, and December 31, 2012. Patients who experienced ischemic stroke or transient ischemic stroke before the index date were excluded. Patients who received at least one prescription for ADT within 6 months were defined as the ADT user group. Patients who did not receive at least one prescription for ADT within 6 months were defined as the ADT nonuser group. The patients were followed until the first occurrence of one of the primary outcome measures (ischemic stroke or death) or until December 31, 2013. The primary composite outcome was the time to any cause of death or ischemic stroke., Results: There was no significant difference in the primary composite outcomes in the prostate cancer patients between the ADT user and nonuser groups. Prostate cancer patients who received ADT had a higher mortality rate than those who were not treated with ADT, and the adjusted hazard ratio was 1.907 (95% confidence interval: 1.278-2.844; P = 0.0016) after adjusting for age, comorbidities and comedication use., Conclusion: ADT in the treatment of prostate cancer may not be associated with an increased risk of ischemic stroke. The differences in thromboembolic effects in cardiovascular disease and ischemic stroke secondary to ADT should be further discussed and evaluated prospectively.

Although previous studies demonstrated the risk of ischemic stroke (IS) in patients with head and neck cancer (HNC), the impact of oral antithrombotic therapy (OAT) on this risk has not yet been assessed. We aimed to evaluate the effectiveness and safety of OAT in patients with HNC treated with RT. This retrospective cohort study was performed using the National Health Insurance Research Database of Taiwan. A total of 37,638 patients diagnosed with HNC included in the study were classified as users and nonusers of OAT. Primary outcome was IS or transient ischemic attack (TIA), and secondary outcomes were death and major bleeding. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). There was no significant difference in the risk of IS or TIA between patients on continuous OAT and nonusers (adjusted HR, 0.812; 95% CI, 0.199-3.309). The risk of major bleeding was not significantly different between the groups. From a national population database, we did not find an association between OAT and decreasing risk of ischemic stroke/TIA or increasing hazard of major bleeding., Competing Interests: The authors declare that they have no competing interests.

Background: Several studies have identified correlations between cancer and increased risks of ischemic stroke (IS), particularly following radiotherapy (RT) or chemotherapy (CT). However, data regarding relative risks of IS in oral cancer are limited. The aim of this study was to compare hazard ratios (HR) of IS among oral cancer patients treated with and without RT, CT, or both (CCRT)., Methods: We analyzed data collected by the Taiwan National Health Insurance Research Database (NHIRD) from 1996 to 2009, which covered approximately 99.5% of the medical claims submitted nationally. A total of 21,853 patients diagnosed with oral cancer from 2000 to 2008 were included. The Cox proportional hazard model was used to estimate the HRs of IS among different treatment modalities and a matched cohort., Results: The overall risk of IS was 1.24-fold greater in patients treated with RT/CT/CCRT than those treated with surgery alone and 1.08-fold greater for surgery with adjuvant therapy (radiotherapy or chemotherapy after surgery) after adjusting for confounding factors. The incidence of IS was 0.23-fold lower in matched control group than in the oral cancer cohort. In subgroup analysis, patients who received RT/CT/CCRT and aged <40 years old were at a 2.77-fold greater risk for IS than age-matched patients who underwent surgery alone, although this difference decreased with patient age., Conclusions: Oral cancer patients, particularly those aged <40 years, who underwent RT or CT are at increased risks for IS. Other significant risk factors for IS included Charlson comorbidity index (CCI)>1, hypertension, coronary artery disease, and atrial fibrillation.