A new study suggests that aromatase inhibitors are associated with increased risks for cardiovascular outcomes compared with tamoxifen in women with breast cancer. The findings were published in the journal Circulation.
The population-based cohort study used data from the UK Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. The population comprised women with newly diagnosed breast cancer receiving hormonal treatment with aromatase inhibitors or tamoxifen (n=17,922).
Aromatase inhibitor use was associated with 86 per cent higher risk for heart failure (HR, 1.86; 95% CI, 1.14-3.03) and 50 per cent higher risk for cardiovascular mortality (HR, 1.50; 95% CI, 1.11-2.04) compared with tamoxifen use. Women receiving aromatase inhibitors also showed a trend towards increased risks for myocardial infarction (HR, 1.37; 95% CI, 0.88-2.13) and ischemic stroke (HR, 1.19; 95% CI, 0.82-1.72).
The authors commented: "The increased risk of cardiovascular events associated with aromatase inhibitors should be balanced with their favorable clinical benefits compared with tamoxifen." They call for further research to substantiate the findings and investigate cardiovascular risk based on the type of aromatase inhibitor and a history of cardiovascular disease.
