乳腺癌妇女辅助内分泌疗法所带来的心血管风险:基于人口的队列研究
Iokfai Cheang1,2,3, Ying Gue4,5, Mei-Zhen Wu1,2
1Division of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen Hospital, Shenzhen, 518009, China.
BMC cancer
|July 2, 2025
概括
芳酶抑制剂 (AIs) 增加心血管风险在绝经后的乳腺癌患者相比,他莫西芬 (TMX). 接受TMX治疗的年轻患者可能体验到较少的心血管保护,需要进一步研究.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 塔莫西芬 (TMX) 和芳香酶抑制剂 (AI) 是非转移性乳腺癌的标准内分泌疗法.
- 评估TMX与AI的心血管风险对比对于患者管理至关重要.
研究的目的:
- 在不同年龄组的非转移性乳腺癌患者中评估与TMX和AI疗法相关的心血管风险.
- 为了比较TMX和AI用户之间主要不良心血管事件 (MACE) 的发生率.
主要方法:
- 使用新诊断的非转移性乳腺癌患者的真实世界数据,采用了队列研究设计.
- 患者按年龄 (<45岁和>55岁) 和内分泌治疗类型 (TMX或AI) 分层.
- 结果包括冠状动脉疾病,心肌梗塞,缺血性中风,心力衰竭,心房动和心血管死亡率,随访时间为2022年12月31日.
主要成果:
- 在55岁以上的患者中,人工智能使用者与TMX使用者相比,对大多数心血管结果 (包括MACE) 的风险显著更高.
- 在45岁以下的患者中,人工智能使用者与TMX使用者相比,患心力衰竭和心房的住院风险增加.
- 虽然没有统计学意义,但在年轻的人工智能用户中观察到MACE增加的趋势.
结论:
- 芳酶抑制剂与更高的心血管事件的风险相关 绝经后的乳腺癌患者与tamoxifen相比.
- 在年轻的患者中,他莫西芬对心血管的益处可能不那么明显.
- 需要进一步的研究来证实这些发现,并解决有关更年期状态和混因素的局限性.
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