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Treatment with aromatase inhibitors and markers of cardiovascular disease

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ABSTRACT

Purpose

The cardiovascular effects of estrogen deprivation induced by aromatase inhibitors are unknown. We carried out a cross-sectional study to evaluate the effect of estrogen deprivation induced by aromatase inhibitors on markers of cardiovascular risk.

Methods

We enrolled 410 postmenopausal women: 200 consecutive breast cancer patients treated with aromatase inhibitors for a median of 53 months (range 23–122) and 210 volunteer controls. Carotid intima-media thickness, presence of carotid stenosis, and presence of abdominal aortic aneurism were evaluated through an ultrasound examination.

Results

Average carotid intima-media thickness was 0.97 ± 0.02 mm and 1.08 ± 0.02 mm for breast cancer group and control group, respectively (p < 0.005). The incidence of carotid stenosis in the two groups was similar: 24.2 % in the breast cancer group and 28.6 % in the control group (OR 0.80; 95 % CI 0.51–1.25; p = 0.32). No aneurismatic dilatation of the aorta was recorded. Average abdominal aortic diameter was 14.9 ± 2.4 mm in the breast cancer group and 15.0 ± 2.4 mm in the control group.

Conclusions

Our study showed no association between treatment with aromatase inhibitors for five or less years and increased carotid intima-media thickness and higher prevalence of carotid stenosis or abdominal aortic aneurism. The lack of impact on these markers suggests that cardiovascular risk is not increased by treatment with aromatase inhibitors.

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Acknowledgments

We thank all the women who participated into the study. We also thank Simona Pastorino (Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino—IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy) for administrative support.

Author Contribution

Conception and design: L. Del Mastro, D. Palombo, and P. Bruzzi. Administrative support: S. Pastorino. Provision of study materials or patients: E. Blondeaux, D. Musio, M. Lambertini, V. Gazzola, F. Poggio, S. Vecchio, A. Levaggi, A. D’Alonzo, M.C. Perfumo, C. Bighin, and S. Giraudi. Collection and assembly of data: E. Blondeaux, D. Musio, M. Lambertini, V. Gazzola, F. Poggio, S. Vecchio, A. Levaggi, A. D’Alonzo, M.C. Perfumo, C. Bighin, and S. Giraudi. Data analysis and interpretation: E. Blondeaux, L. Del Mastro, P. Bruzzi. L. Del Mastro, and P. Bruzzi, who had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Manuscript writing: E. Blondeaux, L. Del Mastro, P. Bruzzi, and M. Lambertini. Final approval of the manuscript: all the authors.

Author information

Authors and Affiliations

  1. Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy

    Eva Blondeaux, Matteo Lambertini, Francesca Poggio, Stefania Vecchio, Alessia D’Alonzo, Claudia Bighin & Sara Giraudi

  2. Department of Vascular and Endovascular Surgery U.O. Chirurgia vascolare ed endovascolare IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy

    Debora Musio, Valerio Gazzola, Maria Cecilia Perfumo & Domenico Palombo

  3. Department of Epidemiology, IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy

    Paolo Bruzzi

  4. Department of Medicine, BrEAST Data Centre, Institut Jules Bordet, l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium

    Matteo Lambertini

  5. S.S. Sviluppo di Terapie Innovative Relating to Department of Medical Oncology IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genova, Italy

    Alessia Levaggi & Lucia Del Mastro

  6. Università degli studi di Genoa, Via Balbi 5, 16126, Genova, Italy

    Domenico Palombo

Authors
  1. Eva Blondeaux
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  2. Debora Musio
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  3. Paolo Bruzzi
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  4. Matteo Lambertini
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  5. Valerio Gazzola
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  6. Francesca Poggio
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  7. Stefania Vecchio
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  8. Alessia Levaggi
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  9. Alessia D’Alonzo
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  10. Maria Cecilia Perfumo
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  11. Claudia Bighin
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  12. Sara Giraudi
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  13. Domenico Palombo
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  14. Lucia Del Mastro
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Corresponding author

Correspondence to Lucia Del Mastro.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study complies with the current laws of the country in which it was performed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Blondeaux, E., Musio, D., Bruzzi, P. et al. Treatment with aromatase inhibitors and markers of cardiovascular disease. Breast Cancer Res Treat 160, 261–267 (2016). https://doi.org/10.1007/s10549-016-3985-7

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  • DOI: https://doi.org/10.1007/s10549-016-3985-7

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