Study Finds Estrogen Blockers Do Not Elevate Coronary Heart Disease Risk in Breast Cancer Cases
New evidence shows that extended estrogen suppression treatment using aromatase inhibitors for hormone receptor-positive postmenopausal breast cancer is safe; it does not increase the risk of coronary artery calcification, a sign of active coronary atherosclerosis, as some prior studies had indicated.
An article in the Canadian Journal of Cardiology, details the findings from a retrospective, cross-sectional observational study that investigated the association between the duration of aromatase inhibitor treatment and the severity of coronary artery calcification in postoperative breast cancer patients.
Lead investigator Yu Hiasa, MD, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan, explains, “Although there is an ongoing discussion on the optimal duration of aromatase inhibitor therapy (5 years or 10 years), our data suggest that longer aromatase inhibitor use (as often used to prevent or suppress late recurrences or spread of breast cancer) is safe, at least in regard to coronary artery calcification.”
The investigators conducted a single-center, retrospective, cross-sectional observational study among 357 postmenopausal breast cancer patients who initiated adjuvant endocrine therapy with aromatase inhibitors for breast cancer between August 2010 and October 2022 as outpatients. Coronary artery calcification was quantified using a visual ordinal scoring system, and patient characteristics were assessed based on the presence of coronary artery calcification. Independent risk factors for elevated coronary artery calcification scores were identified through a multivariable logistic regression model.
Co-investigator Akinori Higaki, MD, PhD, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan, adds, "Our analysis of the postoperative breast cancer patient cohort revealed that the duration of treatment with aromatase inhibitors and the presence of osteoporosis were not associated with coronary artery calcification."
Reference: Impact of Aromatase Inhibitors Treatment Duration on Coronary Artery Calcification in Postoperative Patients with Breast Cancer, Canadian Journal of Cardiology (2024). DOI: 10.1016/j.cjca.2024.05.012
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