Coronary heart disease mortality after 5 years of adjuvant tamoxifen therapy: results from a randomized trial.
From January 1, 1983, through December 31, 1992, a total of 4610 patients entered a randomized trial that compared mortality among patients receiving 2 years of adjuvant tamoxifen therapy with that in patients receiving 5 years of adjuvant tamoxifen therapy, 4175 of whom were recurrence free after 2 years of tamoxifen therapy. Among the 2046 patients randomly assigned to the 5-year group all-cause mortality, breast cancer-specific mortality, and the incidence of contralateral breast cancer were reduced, compared with those among 2129 patients randomized in the 2-year group, but the incidence of endometrial cancer was increased. In addition, mortality from coronary heart disease was statistically significantly reduced in the 5-year group, compared with that in the 2-year group (hazard ratio = 0.67, 95% confidence interval = 0.47 to 0.94; P = .022 [two-sided Wald test]). Ten years after surgery, 2.1% of the patients in the 5-year group and 3.5% of those in the 2-year group had died from coronary heart disease. No statistically significant increases in mortality from other heart diseases, cerebrovascular diseases, or other vascular diseases were observed.
Nordenskjöld
Bo
B
Department of Oncology, Linköping University Hospital, Linköping, Sweden. bo.nordenskjold@lio.se
Rosell
Johan
J
Rutqvist
Lars-Erik
LE
Malmström
Per-Olof
PO
Bergh
Jonas
J
Bengtsson
Nils-Olof
NO
Hatschek
Thomas
T
Wallgren
Arne
A
Carstensen
John
J
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000517:prevention & control; D017024:Chemotherapy, Adjuvant; D003327:Coronary Disease / Q000401:mortality*; D004334:Drug Administration Schedule; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D016017:Odds Ratio; D017698:Postmenopause; D016016:Proportional Hazards Models; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D013629:Tamoxifen / Q000008:administration & dosage*; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D020847:Estrogen Receptor Modulators; D013629:Tamoxifen