Cardiotoxicity of Sequential Aromatase Inhibitors Use in Women with Breast Cancer.

Cardiotoxicity of Sequential Aromatase Inhibitors Use in Women with Breast Cancer. Am J Epidemiol. 2020 Apr 27;: Authors: Khosrow-Khavar F, Bouganim N, Filion KB, Suissa S, Azoulay L Abstract The association between aromatase inhibitors and cardiovascular outcomes is controversial. While some observational studies have assessed their cardiovascular safety as up-front treatments, their cardiotoxic effects as sequential treatments with tamoxifen remains unknown. Thus, we conducted a population-based cohort study using the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. A prevalent new-user design was used to propensity score match, in a 1:2 ratio, patients switching from tamoxifen to aromatase inhibitors to patients continuing tamoxifen between 1998 and 2016. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the study outcomes (myocardial infarction, ischemic stroke, heart failure, and cardiovascular mortality). Overall, 1,962 patients switching to aromatase inhibitors were matched to 3,874 patients continuing tamoxifen. Compared with tamoxifen, aromatase inhibitors were associated with an increased risk of myocardial infarction (HR=2.08; 95% CI: 1.02, 4.27). The hazard ratio was elevated with ischemic stroke (HR=1.58; 95% CI: 0.85, 2.93), heart failure (HR=1.69; 95% CI: 0.79, 3.62),...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research