Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

CVD Risk After Aromatase Inhibitor Use

JAMA Oncol; ePub 2016 Apr 21; Haque, Shi, et al

Aromatase inhibitor (AI) users do not have an elevated risk of the most serious cardiovascular events (ie, cardiac ischemia or stroke) when compared with tamoxifen users, according to a retrospective cohort of 13,272 postmenopausal women with breast cancer diagnosed from January 1, 1991 to December 31, 2010 and followed up for 21 years. Women were grouped by endocrine therapy status (tamoxifen citrate only, AI only, both, or neither). Researchers found:

• During 72,886 person-years in 13,273 women (mean age, 66.8 years), 3,711 CVD events were observed.

• AI-only users had a similar risk of cardiac ischemic (aHR=0.97) and stroke (aHR=0.97) as tamoxifen-only users, in multivariable analyses.

• There was an increased risk of other CVD (dysrhythmia, valvular dysfunction, and pericarditis; aHR=1.29), in women who used AIs only or sequentially after tamoxifen (aHR=1.26) vs tamoxifen as well as nonhormone users (aHR=1.18).

Citation: Haque R, Shi J, Schottinger JE, et al. Cardiovascular disease after aromatase inhibitor use. [Published online ahead of print April 21, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.0429.