Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial. The Scottish Breast Cancer Committee.
OBJECTIVE
To investigate the incidence of fatal myocardial infarction in women in the two randomised arms of the Scottish adjuvant tamoxifen trial.


METHODS
Retrospective review of hospital notes to determine with the greatest possible certainty women who had died of an acute myocardial infarction.


METHODS
Scottish Cancer Trials Office, the University of Edinburgh.


METHODS
1070 postmenopausal women with operable breast cancer who were randomised to receive either adjuvant tamoxifen for five years or until relapse (539 patients) or tamoxifen for at least six weeks on the confirmation of first recurrence (531 patients).


METHODS
Incidence of fatal myocardial infarction in women with no known or suspected systemic cancer.


RESULTS
Of the 200 women who died in the adjuvant tamoxifen arm of the trial, 44 were free of cancer at death and 10 of these died of myocardial infarction. In the observation arm 251 women died, of whom 61 showed no evidence of systemic cancer and 25 had a fatal myocardial infarction. The incidence of fatal myocardial infarction in the two groups was significantly different (chi 2 = 6.88, p = 0.0087).


CONCLUSIONS
Tamoxifen given for at least five years as adjuvant therapy for breast cancer seems to have a cardioprotective oestrogen-like effect in postmenopausal women.
McDonald
C C
CC
Scottish Cancer Trials Office (Medical Research Council), Medical School, Edinburgh.
Stewart
H J
HJ
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control*; D012189:Retrospective Studies; D012606:Scotland; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*
D013629:Tamoxifen