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Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis

BACKGROUND: Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs a...

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Autores principales: He, Yang, Zhang, Jianhua, Shen, Guofang, Liu, Lin, Zhao, Qingwei, Lu, Xiaoyang, Yang, Hongyu, Hong, Dongsheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820915/
https://www.ncbi.nlm.nih.gov/pubmed/31665091
http://dx.doi.org/10.1186/s40360-019-0339-1
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author He, Yang
Zhang, Jianhua
Shen, Guofang
Liu, Lin
Zhao, Qingwei
Lu, Xiaoyang
Yang, Hongyu
Hong, Dongsheng
author_facet He, Yang
Zhang, Jianhua
Shen, Guofang
Liu, Lin
Zhao, Qingwei
Lu, Xiaoyang
Yang, Hongyu
Hong, Dongsheng
author_sort He, Yang
collection PubMed
description BACKGROUND: Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. METHODS: Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Seventeen studies, which included 44,411 subjects, were included in our analyses. The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545–1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR = 1.1564, 95% CI: 1.0656–1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. CONCLUSIONS: These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.
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spelling pubmed-68209152019-11-04 Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis He, Yang Zhang, Jianhua Shen, Guofang Liu, Lin Zhao, Qingwei Lu, Xiaoyang Yang, Hongyu Hong, Dongsheng BMC Pharmacol Toxicol Research Article BACKGROUND: Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. METHODS: Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Seventeen studies, which included 44,411 subjects, were included in our analyses. The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545–1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR = 1.1564, 95% CI: 1.0656–1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. CONCLUSIONS: These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens. BioMed Central 2019-10-29 /pmc/articles/PMC6820915/ /pubmed/31665091 http://dx.doi.org/10.1186/s40360-019-0339-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
He, Yang
Zhang, Jianhua
Shen, Guofang
Liu, Lin
Zhao, Qingwei
Lu, Xiaoyang
Yang, Hongyu
Hong, Dongsheng
Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title_full Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title_fullStr Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title_full_unstemmed Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title_short Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
title_sort aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820915/
https://www.ncbi.nlm.nih.gov/pubmed/31665091
http://dx.doi.org/10.1186/s40360-019-0339-1
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