Tamoxifen improves endothelial function and reduces carotid intima-media thickness in postmenopausal women.
BACKGROUND
Tamoxifen is a selective estrogen-receptor modulator shown to improve several cardiovascular risk factors in postmenopausal women with breast cancer. In animal studies tamoxifen inhibits the progression of atherosclerosis. Although the presence of a history with tamoxifen treatment is related to a lower intima-media thickness (IMT) of the common carotid artery, data from controlled follow-up studies are lacking to support this observation.


METHODS
We examined 14 postmenopausal women with early stage breast cancer with indication for tamoxifen treatment (20 mg/d) and 13 healthy postmenopausal women. Flow-mediated dilatation (FMD) of the brachial artery, combined carotid IMT, and aortic pulse wave were measured before and 6 months after treatment in the tamoxifen group and at the same times in the control group.


RESULTS
FMD and IMT were significantly increased and decreased, respectively, in the treatment group compared to the control group (FMD: +2.2% +/- 0.9% vs +0.085% +/- 1%, P =.012; IMT: -0.088 +/- 0.03 mm vs +0.04 +/- 0.03 mm, P =.018, mean +/- standard error of the mean, treatment vs control group). These differences remained significant even when adjusted for age, duration of menopause, and cardiovascular risk factors. Low-density lipoprotein cholesterol was also significantly reduced after tamoxifen treatment.


CONCLUSIONS
Tamoxifen treatment slows the progression of atherosclerosis in postmenopausal women with breast cancer as assessed by changes in carotid IMT. An improvement in endothelial function and blood lipid profile may be the reason for this beneficial effect.
Stamatelopoulos
Kimon S
KS
Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece. stamatelopoulosk@yahoo.gr
Lekakis
John P
JP
Poulakaki
Nikiforita A
NA
Papamichael
Christos M
CM
Venetsanou
Kyriaki
K
Aznaouridis
Konstantinos
K
Protogerou
Athanasios D
AD
Papaioannou
Theodoros G
TG
Kumar
Sanjay
S
Stamatelopoulos
Stamatios F
SF
D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D002278:Carcinoma in Situ / Q000188:drug therapy; D002339:Carotid Arteries / Q000166:cytology / Q000187:drug effects / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects*; D011673:Pulsatile Flow / Q000187:drug effects; D013629:Tamoxifen / Q000494:pharmacology*; D017539:Tunica Intima / Q000166:cytology / Q000187:drug effects*; D017540:Tunica Media / Q000166:cytology / Q000187:drug effects*
D013629:Tamoxifen