Prospective cohort study of ischemic cardiotoxicity of aromatase inhibitors in postmenopausal early breast cancer patients in Denmark

There is an unresolved concern about ischemic cardiotoxicity of aromatase inhibitor treatment (AIT) in breast cancer. A prospective study in Denmark investigated ischemic cardiotoxicity of AIT for early breast cancer (EBC) in postmenopausal patients. Among 29,118 patients with no history of selected cardiovasculare disease, major adverse cardiovascular events (MACE) were seen in 4.3 per 1000 person-years of follow-up among patients allocated to AIT and 4.1 per 1000 person-years among patients not allocated to AIT (aHR 0.91; 95% CI 0.73-1.14). Among 3517 patients with a history of selected cardiovascular disease MACE were seen in 12.4 per 1000 person-years among patients allocated to AIT and 12.1 per 1000 person-years in patients not allocated to AIT (HR 0.81; 95% CI 0.58-1.15). The authors conclude that these finding do not support a clinical relevant ischemic cardiotoxicity potential of AIT in postmenopausal EBC patients.