title: Cardiac glycosides and the risk of breast cancer in women with chronic heart failure and supraventricular arrhythmia.
abstract: The aim of this study is to determine whether the use of cardiac glycosides (CGs), drugs used in the treatment of congestive heart failure (CHF) and supra-ventricular arrhythmia, is associated with an increased risk of breast cancer. A cohort of 53,454 women newly diagnosed with CHF or supra-ventricular arrhythmia between January 1, 1988 and December 31, 2010, followed until December 31, 2012, was identified using the United Kingdom Clinical Practice Research Datalink. A nested case-control analysis was performed, where all incident cases of breast cancer occurring during follow-up were identified and matched with up to 10 controls on age, cohort entry date, and duration of follow-up. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) of incident breast cancer associated with the use of CGs, along with measures of cumulative duration of use and dose. All analyses considered a one year lag period prior to the event, necessary for latency considerations and to minimize detection bias. The 898 breast cancer cases diagnosed beyond one year of follow-up were matched to 8,940 controls. Overall, use of CGs was not associated with an increased risk of breast cancer when compared to non-use (OR 1.07, 95 % CI 0.90-1.26). Furthermore, the risk did not vary with cumulative duration of use or cumulative dose. The findings of this large population-based study indicate that the use of CGs is not associated with an increased risk of breast cancer. This should provide reassurance to physicians and patients using these drugs.
authors.affiliation: Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Sainte-Catherine, H-425.1, Montreal, QC, H3T 1E2, Canada.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Couraud
authors.forename: Sophie
authors.initials: S
authors.lastname: Dell'Aniello
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Bouganim
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000209:etiology; D002301:Cardiac Glycosides / Q000008:administration & dosage*; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D002301:Cardiac Glycosides