DOI: 10.1101/19010223Oct 25, 2019Paper

Endocrine therapy use and the risk of cardiovascular disease in postmenopausal breast cancer survivors: two cohort studies in the UK and US

MedRxiv : the Preprint Server for Health Sciences
Anthony MatthewsKrishnan Bhaskaran

Abstract

Objective: Examine the effect of tamoxifen and aromatase inhibitors on 12 clinically relevant individual cardiovascular outcomes in postmenopausal female breast cancer survivors using large-scale datasets from the UK and US. Design: Two prospective cohort studies Setting: Population-based using data from the UK Clinical Practice Datalink linked with Hospital Episode Statistics (2002-2016), and the US Surveillance, Epidemiology and End Results-Medicare database (2008-2013). Participants: 10005 and 22027 postmenopausal women with breast cancer in the UK and US respectively. Exposures: Aromatase inhibitor compared with tamoxifen use; the US cohort additionally included a comparison with an unexposed group of women with oestrogen or progesterone receptor positive breast cancer but no endocrine therapy use. Outcomes: 12 clinically relevant individual cardiovascular outcomes (and two composite coronary and venous thromboembolic outcomes) Results: In both the UK and the US, there was evidence of an increased risk of coronary artery disease in aromatase inhibitor compared with tamoxifen users (UK incidence rate: 10.18 vs 6.87 per 1000 person-years, HR: 1.29, 0.94-1.76; US incidence rate: 35.26 vs 26.95 per 1000 person-years, HR: 1.29, ...Continue Reading

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