Site Editor
William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Wednesday, November 27, 2024
The results of a Danish study published in The Lancet Oncology suggest that aromatase inhibitors may not increase the risk of ischemic cardiotoxicity in postmenopausal patients with early breast cancer. In their prospective cohort study, Marie Lund, PhD, of Statens Serum Institut, Copenhagen, and colleagues found no evidence of an association between aromatase inhibitor treatment and a clinically relevant higher risk of ischemic cardiotoxicity among these patients, with or without a history of selected cardiovascular disease.
A total of 32,635 postmenopausal patients diagnosed with breast cancer between January 2009 and December 2020 were included in the study, drawn from the nationwide Danish Breast Cancer Cooperative Group clinical database. Participants had no history of other primary cancer, resided in Denmark for 2 or more years, and were included in Danish cancer treatment protocols.
Reporting on the 29,118 participants with no history of selected cardiovascular disease (defined as ischemic heart disease, ischemic stroke, and heart failure), the investigators observed 510 two-point major adverse cardiovascular events (ie, acute myocardial infarction or ischemic stroke) among the 22,135 patients who received aromatase inhibitor treatment and 170 among the 6,983 who did not. They reported an adjusted hazard ratio (HR) of 0.91 (95% confidence interval [CI] = 0.73–1.14) for patients who were allocated to the treatment vs those who were not. Regarding the 3,517 patients with a history of selected cardiovascular disease, the researchers observed 158 two-point major adverse cardiovascular events among the 2,661 patients who were allocated to aromatase inhibitor treatment and 50 among the 856 who were not (adjusted HR = 0.81; 95% CI = 0.58–1.15)
Investigators summarized that the study findings do not support that concerns about ischemic cardiotoxicity should prevent treatment with aromatase inhibitors in patients with early breast cancer.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
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