Aromatase Inhibitors and the Risk of Cardiovascular Outcomes in Women With Breast Cancer: A Population-Based Cohort Study
Authors' conclusion
In this population-based study, aromatase inhibitors were associated with increased risks of heart failure and cardiovascular mortality compared with tamoxifen. There were also trends toward increased risks, although nonsignificant, of myocardial infarction and ischemic stroke.
Study context
- Population
- Women newly diagnosed with breast cancer initiating hormonal therapy, UK CPRD linked to HES and ONS, 1998–201617,922 initiated treatment
- Participants
- 23,525 women
- Exposure
- Aromatase inhibitors vs tamoxifen
- Aromatase inhibitorsn = 8,139
- Tamoxifenn = 9,783reference
- Outcome
- MI, ischemic stroke, HF and CV mortality
Methodological detailsinverse probability of treatment and censoring weighting
- Inverse probability of treatment and censoring weighting
Main finding
As reported in the abstract
Aromatase inhibitors
- HF
- 5.4 per 1000 person-years
- CV mortality
- 9.5 per 1000 person-years
- MI
- 3.9 per 1000 person-years
- Ischemic stroke
- 5.6 per 1000 person-years
Tamoxifen
- HF
- 1.8 per 1000 person-years
- CV mortality
- 4.7 per 1000 person-years
- MI
- 1.8 per 1000 person-years
- Ischemic stroke
- 3.2 per 1000 person-years
HF
Aromatase inhibitors5.4 per 1000 person-years
Tamoxifen1.8 per 1000 person-years
CV mortality
Aromatase inhibitors9.5 per 1000 person-years
Tamoxifen4.7 per 1000 person-years
MI
Aromatase inhibitors3.9 per 1000 person-years
Tamoxifen1.8 per 1000 person-years
Ischemic stroke
Aromatase inhibitors5.6 per 1000 person-years
Tamoxifen3.2 per 1000 person-years
Aromatase inhibitors vs TamoxifenHazard ratio (95% CI)
HF
1.86(1.14–3.03)
CV mortality
1.50(1.11–2.04)
MI
1.37(0.88–2.13)
Ischemic stroke
1.19(0.82–1.72)
Observational data: associations, not effects.
Original publication
Aromatase Inhibitors and the Risk of Cardiovascular Outcomes in Women With Breast Cancer: A Population-Based Cohort Study. Circulation. Published 17 February 2020. doi:10.
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