Related Experiment Video
Updated: Apr 4, 2026
06:18
An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
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Cardiovascular Risks of Aromatase Inhibitors versus Tamoxifen in Postmenopausal Breast Cancer: A Multinational Cohort
Shu-Chen Hu1, Charles E Gaber2, Chiao Lo3
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Clinical Epidemiology
|April 2, 2026
Summary
Aromatase inhibitors (AIs) did not definitively increase cardiovascular risks like MACE or heart failure compared to tamoxifen in postmenopausal breast cancer patients. However, population differences in venous thromboembolism risk highlight the need for personalized endocrine therapy selection.
Area of Science:
- Oncology
- Cardiovascular Medicine
- Pharmacology
Background:
- Aromatase inhibitors (AIs) are standard for postmenopausal hormone receptor-positive (HR+) breast cancer.
- Cardiovascular safety of AIs versus tamoxifen requires further investigation.
Purpose of the Study:
- To compare cardiovascular risks between AIs and tamoxifen in distinct patient populations.
- To assess risks for major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and heart failure (HF).
Main Methods:
- Retrospective cohort study using US SEER-Medicare and Taiwan NHI data (2007-2021).
- Included postmenopausal women with HR+ stage I-III breast cancer.
- Used inverse probability of treatment weighting and cause-specific hazard models.
Main Results:
- AIs showed no definitive increased risk for MACE or HF compared to tamoxifen in either cohort.
- AI use was associated with significantly lower VTE risk in the US cohort.
- Taiwan cohort showed a non-significant trend towards lower VTE risk with AIs.
Conclusions:
- Aromatase inhibitors are not definitively linked to increased MACE or HF risk versus tamoxifen.
- Population-specific differences in VTE risk necessitate tailored endocrine therapy choices.
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