Key result
Aromatase inhibitors were associated with a higher risk of coronary artery disease compared to tamoxifen (US HR 1.29; 95% CI 1.06-1.55), which appears driven by tamoxifen's protective effects.
Why the study?
The study was conducted to examine the effect of tamoxifen and aromatase inhibitors on the risk of 12 clinically relevant cardiovascular outcomes in postmenopausal female breast cancer survivors.
Do aromatase inhibitors increase cardiovascular risk compared to tamoxifen or no endocrine therapy in postmenopausal breast cancer survivors?
Cohort (n=32,032)
Yes
Do aromatase inhibitors increase cardiovascular risk compared to tamoxifen or no endocrine therapy in postmenopausal breast cancer survivors?
Hazard Ratio: 1.29 (95% CI 1.06–1.55)
Absolute Event Rate: 36.82% vs 26.02%
The apparent higher cardiovascular risk with aromatase inhibitors compared to tamoxifen is driven by the cardioprotective effects of tamoxifen rather than cardiotoxicity of aromatase inhibitors.
Authors
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Supports individualized CAD risk assessment for endocrine therapy; leaves open tamoxifen's potential cardioprotective role.
Matthews et al. (2020) conducted a cohort in postmenopausal breast cancer (n=32,032). Aromatase inhibitors vs. Tamoxifen was evaluated on coronary artery disease (HR 1.29, 95% CI 1.06-1.55). Aromatase inhibitors were associated with a higher risk of coronary artery disease compared to tamoxifen (US HR 1.29; 95% CI 1.06-1.55), which appears driven by tamoxifen's protective effects.
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