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Risks of Aromatase Inhibitor-Related Cardiotoxicity in Patients with Breast Cancer in Asia
Wei-Ting Chang1,2,3, Po-Wei Chen2,4, Hui-Wen Lin4,5
1Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 710402, Taiwan.
Cancers
|February 15, 2022
Summary
Selective estrogen receptor modulators (SERMs) may increase cardiovascular risks in older Asian breast cancer patients compared to aromatase inhibitors (AIs). This highlights the need for careful treatment selection in this demographic.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Aromatase inhibitors (AIs) are preferred endocrine therapy for hormone-positive breast cancer.
- AIs may increase cardiovascular event risk, a concern particularly for younger Asian breast cancer patients.
Purpose of the Study:
- To investigate the cardiovascular safety of selective estrogen receptor modulators (SERMs) versus AIs in Asian breast cancer patients.
- To compare major adverse cardio- and cerebrovascular events (MACCEs) between SERM and AI users.
Main Methods:
- Retrospective cohort study using Taiwanese National Cohort data (2010-2016).
- Identified breast cancer patients initiating SERMs or AIs.
- Follow-up duration averaged five years, analyzing MACCEs and heart failure (HF).
Main Results:
- 16,730 patients received SERMs, 11,728 received AIs.
- AI group was older with more comorbidities.
- Adjusted analysis showed similar MACCEs between groups, but higher HF risk with SERMs.
- Older patients receiving SERMs had significantly higher MACCEs than those receiving AIs.
Conclusions:
- In this Asian cohort, SERMs were associated with a higher risk of cardiovascular events than AIs in older patients or those with advanced cancer.
- Treatment choice between SERMs and AIs may depend on patient age and cancer stage.
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