Observational studyClinical cardiology2019
Are aromatase inhibitors associated with higher myocardial infarction risk in breast cancer patients? A Medicare population-based study.
Observational study in Clinical cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Risk of Cardiovascular Events and Lipid Profile Change in Patients with Breast Cancer Taking Aromatase Inhibitor: A Systematic Review and Meta-Analysis.Current oncology (Toronto, Ont.) · 2023Pooled it
- Association Between Aromatase Inhibitors and Myocardial Infarction Morbidity in Women With Breast Cancer: A Meta-Analysis of Observational Studies.Cancer control : journal of the Moffitt Cancer CenterPooled it
- Cardiovascular Risks of Aromatase Inhibitors versus Tamoxifen in Postmenopausal Breast Cancer: A Multinational Cohort Study.Clinical epidemiology · 2026Article
- Endocrine therapy and risk of cardiovascular disease and mortality in postmenopausal breast cancer survivors.Journal of the National Cancer Institute · 2025Article
- Duration of aromatase inhibitor use and long-term cardiovascular risk in breast cancer survivors.JNCI cancer spectrum · 2025Article
- Effects of aromatase inhibitor therapy on adiposity and cardiometabolic health in postmenopausal women: a controlled cohort extension study.Endocrine connections · 2023Article
- Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer.Breast cancer research and treatment · 2023Article
- The Cardiovascular Risks Associated with Aromatase Inhibitors, Tamoxifen, and GnRH Agonists in Women with Breast Cancer.Current atherosclerosis reports · 2023Review
- Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer.Research square · 2023Article
- Rationale, Strengths, and Limitations of Real-World Evidence in Oncology: A Canadian Review and Perspective.The oncologist · 2022Article
- Risk of Cardiovascular Disease in Women With and Without Breast Cancer: The Pathways Heart Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Article
- Aromatase inhibitors use and risk for cardiovascular disease in breast cancer patients: A population-based cohort study.Breast (Edinburgh, Scotland) · 2021Article
- Article
- Estrogen Receptors: Therapeutic Perspectives for the Treatment of Cardiac Dysfunction after Myocardial Infarction.International journal of molecular sciences · 2021Review
- Effects of tamoxifen and aromatase inhibitors on the risk of acute coronary syndrome in elderly breast cancer patients: An analysis of nationwide data.Breast (Edinburgh, Scotland) · 2020Article
- Cardiotoxicity of Use of Sequential Aromatase Inhibitors in Women With Breast Cancer.American journal of epidemiology · 2020Observational
- Cardiometabolic Effects of Endocrine Treatment of Estrogen Receptor-Positive Early Breast Cancer.Journal of the Endocrine Society · 2019Review
- Are aromatase inhibitors associated with higher myocardial infarction risk in breast cancer patients? A Medicare population-based study.Clinical cardiology · 2019Observational
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundTheoretically, the estrogen deprivation induced by aromatase inhibitors (AIs) might cause ischemic heart disease, but empiric studies have shown mixed results. We aimed to compare AIs and tamoxifen with regard to cardiovascular events among older breast cancer patients outside of clinical trials. We hypothesized that AIs increase the risk of myocardial infarction.
methodsWe identified women age ≥67 years diagnosed with breast cancer from June 30, 2006 to June 1, 2008 in the surveillance, epidemiology, and end results (SEER)-Medicare database, treated with either tamoxifen or an AI, and followed through December 31, 2012. To compare myocardial infarction (MI) risk for the treatment groups of AIs vs tamoxifen, we developed and assigned stabilized probability of treatment weights and used the Fine and Gray model for time to MI with death not related to MI as a competing risk.
resultsOf the cohort of 5648 women, 4690 were treated with AIs and 958 with tamoxifen; a total of 251 patients developed MI, and 22 patients died of MI during the study period while 476 died of other causes. The hazard for MI was not significantly different between AI vs tamoxifen groups (HR = 1.01, 95% CI 0.72-1.42), after adjusting for the following known MI risk factors at the start of adjuvant therapy: diabetes, ischemic heart disease, congestive heart failure, MI, and peripheral vascular disease.
conclusionsIn this SEER-Medicare-based population study, there were no significant differences in the risk of MI between AI and tamoxifen users after adjustment for known risk factors.
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