Risk for stroke and myocardial infarction with abiraterone versus enzalutamide in metastatic prostate cancer patients

•Abiraterone and enzalutamide have comparable efficacy but substantial differences in CV toxicity.•We identified metastatic PC patients treated with ADT and abiraterone or enzalutamide from insurance claims-based database.•Abiraterone use was associated with a 31% increased risk for MI or stroke when compared to enzalutamide.•Enzalutamide may be preferable in patients with baseline high CV risk.