ArticleBreast (Edinburgh, Scotland)2020
Effects of tamoxifen and aromatase inhibitors on the risk of acute coronary syndrome in elderly breast cancer patients: An analysis of nationwide data.
Article in Breast (Edinburgh, Scotland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 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
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 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
- Effect of VSOR/VRAC blocker tamoxifen on contractile activity of primary neonatal cardiomyocytes and isolated perfused heart.BMC research notes · 2026Article
- Endocrine therapy and risk of cardiovascular disease and mortality in postmenopausal breast cancer survivors.Journal of the National Cancer Institute · 2025Article
- Cardiotoxicity in Elderly Breast Cancer Patients.Cancers · 2025Review
- Investigating cardiovascular diseases related to endocrine therapy in hormone receptor-positive early breast cancer: insights from a nationwide real-world study.Cardio-oncology (London, England) · 2025Article
- Duration of aromatase inhibitor use and long-term cardiovascular risk in breast cancer survivors.JNCI cancer spectrum · 2025Article
- Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer.Breast cancer research and treatment · 2023Article
- Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer.Research square · 2023Article
- 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
- Risks of Aromatase Inhibitor-Related Cardiotoxicity in Patients with Breast Cancer in Asia.Cancers · 2022Article
- Increased Risk of Cardiovascular Death in Breast Cancer Patients Without Chemotherapy or (and) Radiotherapy: A Large Population-Based Study.Frontiers in oncology · 2020Article
Corrections and comments
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Authors and funding
11 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAromatase inhibitors (AIs) are the preferred endocrine treatment for postmenopausal hormonal receptor-positive breast cancer. However, there is controversy on the long-term cardiovascular and cerebrovascular safety of AIs over that of tamoxifen.
methodsWe analyzed the National Health Information Database (NHID) of 281,255 women over a 20-year-old diagnosed with breast cancer between 2009 and 2016. Cardiovascular events (CVEs) were defined as the development of the following, acute coronary syndrome (ACS), ischemic and hemorrhagic stroke, defined by using insurance claim records. The model was constructed by Cox proportional hazard regression and this model was used to analyze the effects of AI and tamoxifen on CVE.
resultsWe included 47,569 women for the final analysis. Patients were classified into 'No hormonal treatment (n = 18,807), 'Switch (n = 2097)', 'Tamoxifen (n = 7081)' and 'AI (n = 19,584)'. There were 2147 CVEs in 2032 patients (4.1%). Univariate analysis showed that women with tamoxifen had significantly lower risk for CVEs compared to no-treatment (hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.74-0.97) while AI showed no such effect (HR 0.93, 95% CI 0.84-1.02). After adjusting for other risk factors (hypertension, dyslipidemia, family history), the use of tamoxifen was associated with significant protective effect against ACS (HR 0.63, 95% CI 0.47-0.84).
conclusionsOur results, based on the NHID, supports the protective effect of tamoxifen against CVE in Korean breast cancer patients aged 55 and older that is not seen with AIs. Our results can guide the selection of adjuvant hormonal treatment agents for Korean breast cancer patients based on their risk of developing CVE.
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