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1、ResearchOriginalInvestigationCardiovascularDiseaseAfterAromataseInhibitorUseReinaHaque,PhD;JiaxiaoShi,PhD;JoanneE.Schottinger,MD;JoanieChung,MPH;ChantalAvila,MA;BrittaAmundsen,MA;XiaoqingXu,PharmD;AnaBarac,MD;RowanT.Chlebowski,MDSupplementalcontentatIMPORTANCECardiovascu
2、lardisease(CVD)isanimportantcauseofdeathinolderpatientsjamaoncology.comwithbreastcancer.However,limitedinformationexistsonthelong-termeffectofaromataseinhibitor(AI)useonCVDriskinbreastcancersurvivors.Tothispoint,nootherpopulation-basedstudieshavebeenabletoadjustforCVDris
3、kfactorsorcardiovascularmedications.OBJECTIVETodeterminethelong-terminfluenceofadjuvantendocrinetherapiesonCVDinacohortofpostmenopausalbreastcancersurvivorsinanalysesthataccountedformajorCVDriskfactors,medicationuse,chemotherapy,andradiotherapy.DESIGN,SETTING,ANDPARTICIP
4、ANTSAretrospectivecohortofpostmenopausalwomenwithbreastcancerdiagnosedfromJanuary1,1991,toDecember31,2010,andfollowedupthroughDecember31,2011(maximum,21years[72886person-years]),wasevaluatedusingrecordsfromamanagedcareorganizationwithnearly20communityhospitalsinCaliforni
5、a.Atotalof13273postmenopausalwomenwithhormonereceptor–positivebreastcancerwithoutpriorCVDwereincluded.Cardiovasculardiseaseincidencewascomparedacrossendocrinetherapycategories.Informationondemographics,comorbidity,medication,use,andCVDriskwascapturedfromelectronichealthr
6、ecords.MultivariateCoxproportionalhazardsmodelsusingtime-dependentendocrinedrugusevariablesandpropensityscoreswereconducted.DataanalysiswasconductedfromSeptember15,2014,toFebruary1,2016.EXPOSURESWomenweregroupedbyendocrinetherapystatus(tamoxifencitrateonly,AIonly,both,or
7、neither).MAINOUTCOMESANDMEASURESPerson-yearratesofCVDforeachtherapygroup.RESULTSDuring72886person-yearsin13273women(mean[SD]age,66.8[8.1]years)withfollow-upthrough2011,weobserved3711CVDevents.Inmultivariableanalyses(reportedashazardratio[95%CI]),AI-onlyusershadasimilarri
8、skofcardiacischemia(myocardialinfarctionandangina)(adjusted,0.97[0.78-1.22])andstroke(adjusted,0.97[0.7
