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5α-Reductase inhibitors increase acute coronary syndrome risk in patients with benign prostate hyperplasia

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Abstract

Background

This study explored the possible association between the use of two typical 5ARIs (finasteride and dutasteride) and the risk of acute coronary syndrome (ACS) in patients with benign prostate hyperplasia (BPH).

Methods

From the claims data of the Taiwan National Health Insurance (NHI) Taiwan, we identified 1843 ACS cases among BPH patients and randomly selected 7330 controls without ACS, with a similar mean age of 73 years. Multivariate logistic regression analysis estimated the odds ratio (OR) and 95 % confidence interval (CI) for the relationship between the 5ARIs medications and ACS risk.

Results

We found that BPH patients who had received treatment with both finasteride and dutasteride were at a higher risk of ACS with an OR of 3.47 (95 % CI 1.05–11.5), compared to patients without 5ARIs treatment. Furthermore, the dosage analysis showed that there were no significant associations between ACS risk and uses of a single drug medication regardless the dosages. The ORs for those who took only dutasteride were 1.07 (95 % CI 0.39–2.99) with low dose and 0.73 (95 % CI 0.38–1.44) with high dose. The ORs for those who took only finasteride were 1.30 (95 % CI 0.89–1.92) with low dose and 0.98 (95 % CI 0.19–5.13) with high dose.

Conclusion

This population-based nested case–control study suggests that 5ARI use may increase ACS risk among patients with BPH when patients were exposed to both finasteride and dutasteride.

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Acknowledgments

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212-113002); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092); NRPB Stroke Clinical Trial Consortium (MOST 103-2325-B-039 -006); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and Health and welfare surcharge of tobacco products, China Medical University Hospital Cancer Research Center of Excellence (MOHW104-TDU-B-212-124-002, Taiwan). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.

Conflict of interest

The authors declare that they have no conflict of interest or financial interest invested in this work, either collectively or individually.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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No Informed Consent.

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Author notes

    Authors and Affiliations

    1. Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Yunlin Branch, Yunlin, Taiwan

      C.-H. Chou

    2. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

      C.-L. Lin & F.-C. Sung

    3. Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan

      M.-C. Lin

    4. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan

      F.-C. Sung & C.-H. Kao

    5. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

      C.-H. Kao

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    1. C.-H. Chou
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    2. C.-L. Lin
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    3. M.-C. Lin
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    4. F.-C. Sung
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    Correspondence to F.-C. Sung or C.-H. Kao.

    Additional information

    M.-C. Lin and C.-H. Chou contributed equally to this work.

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    Chou, CH., Lin, CL., Lin, MC. et al. 5α-Reductase inhibitors increase acute coronary syndrome risk in patients with benign prostate hyperplasia. J Endocrinol Invest 38, 799–805 (2015). https://doi.org/10.1007/s40618-015-0263-1

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    • DOI: https://doi.org/10.1007/s40618-015-0263-1

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