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Increased Risk of Heart Disease in Postmenopausal Women With Breast Cancer Taking Aromatase Inhibitors
These data, presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium, indicate that women presenting with breast cancer treatment who have risk factors for cardiovascular disease should be considered for a shorter duration of use of aromatase inhibitors.
"It appears that aromatase inhibitors have a significant increase in cardiotoxic side effects, such as heart attack, angina and heart failure," said Eitan Amir, M.D., a senior fellow in the division of medical oncology and hematology at the Princess Margaret Hospital, Toronto, Canada.
Because some cancers, especially breast cancers, require estrogen to grow and spread, drugs that block estrogen production are often used to treat the disease. Tamoxifen blocks the effect of estrogen in breast tissue, whereas aromatase inhibitors prevent the production of estrogen.
Each class of drugs also have related adverse effects. For example, although tamoxifen blocks estrogen production in breast tissue, it has the opposite effect in uterine tissue. Previous research has shown that extended use of tamoxifen results in a small increase in the risk for endometrial cancer and venous thrombosis.On the other hand, in December 2008, the Food and Drug Administration added a warning label to anastrozole, an aromatase inhibitor, which indicated potential increased risk for heart disease. For this reason, Amir and colleagues conducted a meta-analysis to determine if this increased risk for heart disease occurred with the use of any aromatase inhibitor.
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