ArticleHeart (British Cardiac Society)2021
Endocrine therapy use and cardiovascular risk in postmenopausal breast cancer survivors.
Article in Heart (British Cardiac Society), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 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
- The Evidence Surrounding Non-Alcoholic Fatty Liver Disease in Individuals with Cancer: A Systematic Literature Review.Current oncology (Toronto, Ont.) · 2022Pooled it
- Sodium-glucose cotransporter 2 inhibitors in breast cancer patients on endocrine therapy: a targeted strategy to mitigate long-term cardiometabolic risk.Journal of translational medicine · 2026Review
- Cardiovascular Risks of Aromatase Inhibitors versus Tamoxifen in Postmenopausal Breast Cancer: A Multinational Cohort Study.Clinical epidemiology · 2026Article
- Endocrine regimen and early subclinical atherosclerosis in premenopausal HR+/HER2- breast cancer: real-world evidence and regimen-dependent effects of Sanhuang Decoction.Frontiers in oncology · 2026Article
- The evolution of cardiac changes after breast cancer adjuvant radiotherapy - A six-year follow-up study.Clinical and translational radiation oncology · 2026Article
- Rationale and design of the IMProving Adherence to medications for breast Cancer and cardiovascular disease equiTably (IMPACT) randomized clinical trial.Contemporary clinical trials · 2025Article
- Real-world assessment of thromboembolic risk associated with tamoxifen.Scientific reports · 2025Article
- Endocrine therapy and risk of cardiovascular disease and mortality in postmenopausal breast cancer survivors.Journal of the National Cancer Institute · 2025Article
- Weight change and cardiovascular disease incidence in breast cancer survivors: a nationwide cohort study.Breast cancer research and treatment · 2025Article
- Physical Health Decline After Chemotherapy or Endocrine Therapy in Breast Cancer Survivors.JAMA network open · 2025Article
- Duration of aromatase inhibitor use and long-term cardiovascular risk in breast cancer survivors.JNCI cancer spectrum · 2025Article
- Article
- A disease of her own? Unique features of heart failure in women.Climacteric : the journal of the International Menopause Society · 2024Review
- Cardiotoxicity of Agents Used in Patients With Breast Cancer.JCO oncology practice · 2024Review
- Racial disparities in treatment-related cardiovascular toxicities amongst women with breast cancer: a scoping review.Journal of cancer survivorship : research and practice · 2023Article
- Circulating oxysterols and prognosis among women with a breast cancer diagnosis: results from the MARIE patient cohort.BMC medicine · 2023Article
- Breast conservation therapy decreased heart-specific mortality in breast cancer patients compared with mastectomy.BMC surgery · 2023Article
- 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
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
objectiveExamine the effect of tamoxifen and aromatase inhibitors (AIs) on the risk of 12 clinically relevant cardiovascular outcomes in postmenopausal female breast cancer survivors.
methodsWe carried out two prospective cohort studies among postmenopausal women with breast cancer in UK primary care and hospital data (2002-2016) and US Surveillance, Epidemiology and End Results-Medicare data (2008-2013). Using Cox adjusted proportional hazards models, we compared cardiovascular risks between AI and tamoxifen users; and in the USA, between users of both drug classes and women receiving no endocrine therapy.
results10 005 (UK) and 22 027 (USA) women with postmenopausal breast cancer were included. In both countries, there were higher coronary artery disease risks in AI compared with tamoxifen users (UK age-standardised incidence rate: 10.17 vs 7.51 per 1000 person-years, HR: 1.29, 95% CI 0.94 to 1.76; US age-standardised incidence rate: 36.82 vs 26.02 per 1000 person-years, HR: 1.29, 95% C I1.06 to 1.55). However, comparisons with those receiving no endocrine therapy (US data) showed no higher risk for either drug class and a lower risk in tamoxifen users (age-standardised incidence rate tamoxifen vs unexposed: 26.02 vs 35.19 per 1000 person-years, HR: 0.74, 95% 0.60 to 0.92; age-standardised incidence rate AI vs unexposed: 36.82 vs 35.19, HR: 0.96, 95% CI 0.83 to 1.10). Similar patterns were seen for other cardiovascular outcomes (arrhythmia, heart failure and valvular heart disease). As expected, there was more venous thromboembolism in tamoxifen compared with both AI users and those unexposed.
conclusionsHigher risks of several cardiovascular outcomes among AI compared with tamoxifen users appeared to be driven by protective effects of tamoxifen, rather than cardiotoxic effects of AIs.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.