The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Cardiology, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
Cancer Control. 2022 Jan-Dec;29:10732748221132512. doi: 10.1177/10732748221132512.
The cardiovascular toxicity of aromatase inhibitors (AIs) for women with estrogen receptor-positive breast cancer is controversial. We aimed to evaluate the association between AIs and the risk of myocardial infarction (MI) in women with estrogen receptor-positive breast cancer based on real-world studies.
PubMed, Embase, and Cochrane Library were searched to identify studies that estimated the association between MI risk and AIs. A random-effects model was used to evaluate the hazard ratio (HR) and 95% confidence intervals (CIs) of the predefined outcomes.
A total of 134 476 patients from eight cohort studies were enrolled in our analysis. For MI incidence, no significant difference was found between the users of AIs and non-users (HR: .98, 95% CI: .83-1.17). The subgroup analysis of patients without a history of cardiovascular disease (CVD) suggested a reduced risk of MI (HR: .86, 95% CI: .77-.96). No significant difference was found for ischemic stroke (HR: .93, 95% CI: .82-1.07) and heart failure (HR: 1.24, 95% CI: .92-1.66) between the two groups.
Based on real-world data, AIs may be a safe treatment route for patients with estrogen receptor-positive breast cancer and those with a history of CVD. AIs caused a major decrease in MI in patients without CVD history. However, more in-depth investigations are needed to explore the association between AI use and the incidence of MI in the treatment of estrogen receptor-positive breast cancer.
芳香化酶抑制剂（AIs）对雌激素受体阳性乳腺癌患者的心血管毒性存在争议。我们旨在基于真实世界的研究评估 AI 与雌激素受体阳性乳腺癌患者心肌梗死（MI）风险之间的关联。
我们检索了 PubMed、Embase 和 Cochrane Library，以确定评估 AI 与 MI 风险之间关联的研究。我们使用随机效应模型来评估预定结局的风险比（HR）和 95%置信区间（CI）。
共有来自 8 项队列研究的 134476 名患者纳入了我们的分析。对于 MI 发生率，AI 使用者与非使用者之间无显著差异（HR：0.98，95%CI：0.83-1.17）。对于无心血管疾病（CVD）史的患者的亚组分析表明，MI 风险降低（HR：0.86，95%CI：0.77-0.96）。两组之间缺血性卒中和心力衰竭的发生率无显著差异（HR：0.93，95%CI：0.82-1.07 和 HR：1.24，95%CI：0.92-1.66）。
基于真实世界的数据，AIs 可能是雌激素受体阳性乳腺癌患者和有 CVD 史患者的安全治疗途径。AIs 使无 CVD 史患者的 MI 发生率显著降低。然而，需要更深入的研究来探讨 AI 应用与雌激素受体阳性乳腺癌治疗中 MI 发生率之间的关联。
