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他莫昔芬使用与乳腺癌女性急性心肌梗死之间的关联。

Association between tamoxifen use and acute myocardial infarction in women with breast cancer.

作者信息

Lai Shih-Wei, Lin Cheng-Li, Liao Kuan-Fu

机构信息

College of Medicine, China Medical University.

Department of Family Medicine, and.

出版信息

Medicine (Baltimore). 2019 Jan;98(3):e13925. doi: 10.1097/MD.0000000000013925.

Abstract

The relationship between tamoxifen use and acute myocardial infarction in women with breast cancer remains uncertain. The goal of the study was to assess whether tamoxifen use could be associated with acute myocardial infarction in women with breast cancer in Taiwan.A population-based case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program. Totally, 489 women with breast cancer aged 20 to 84 years having the first episode of acute myocardial infarction from 2000 to 2011 were found as the cases. In addition, 1718 women with breast cancer aged 20 to 84 years without any type of ischemic heart disease were selected as the matched controls. Ever use of tamoxifen was classified as the studied women who had at least a prescription for tamoxifen before the index date. Never use of tamoxifen was classified as the studied women who never had a prescription for tamoxifen before the index date. We used the multivariable logistic regression model to estimate the odds ratio (OR) and 95% confidence interval (CI) for acute myocardial infarction associated with tamoxifen use.In a multivariable-adjusted analysis, women with acute myocardial infarction were 1.71 times more likely to be exposed to tamoxifen than those women without acute myocardial infarction (adjusted OR 1.71, 95% CI 1.38-2.13).The odds of tamoxifen use are 1.71 times higher in women with acute myocardial infarction versus those women without acute myocardial infarction in Taiwan.

摘要

他莫昔芬的使用与乳腺癌女性急性心肌梗死之间的关系仍不明确。本研究的目的是评估在台湾,他莫昔芬的使用是否与乳腺癌女性的急性心肌梗死有关。

我们进行了一项基于人群的病例对照研究,以分析台湾国民健康保险计划的数据库。总共,489名年龄在20至84岁之间、在2000年至2011年首次发生急性心肌梗死的乳腺癌女性被作为病例。此外,1718名年龄在20至84岁之间、无任何类型缺血性心脏病的乳腺癌女性被选为匹配对照。曾经使用他莫昔芬被定义为在索引日期之前至少有一张他莫昔芬处方的研究对象。从未使用他莫昔芬被定义为在索引日期之前从未有过他莫昔芬处方的研究对象。我们使用多变量逻辑回归模型来估计与使用他莫昔芬相关的急性心肌梗死的比值比(OR)和95%置信区间(CI)。

在多变量调整分析中,发生急性心肌梗死的女性接触他莫昔芬的可能性是未发生急性心肌梗死女性的1.71倍(调整后的OR为1.71,95%CI为1.38 - 2.13)。

在台湾,发生急性心肌梗死的女性使用他莫昔芬的几率比未发生急性心肌梗死的女性高1.71倍。

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