Treatment with aromatase inhibitors and markers of cardiovascular disease.
The cardiovascular effects of estrogen deprivation induced by aromatase inhibitors are unknown. We carried out a cross-sectional study to evaluate the effect of estrogen deprivation induced by aromatase inhibitors on markers of cardiovascular risk.



We enrolled 410 postmenopausal women: 200 consecutive breast cancer patients treated with aromatase inhibitors for a median of 53 months (range 23-122) and 210 volunteer controls. Carotid intima-media thickness, presence of carotid stenosis, and presence of abdominal aortic aneurism were evaluated through an ultrasound examination.



Average carotid intima-media thickness was 0.97 ± 0.02 mm and 1.08 ± 0.02 mm for breast cancer group and control group, respectively (p < 0.005). The incidence of carotid stenosis in the two groups was similar: 24.2 % in the breast cancer group and 28.6 % in the control group (OR 0.80; 95 % CI 0.51-1.25; p = 0.32). No aneurismatic dilatation of the aorta was recorded. Average abdominal aortic diameter was 14.9 ± 2.4 mm in the breast cancer group and 15.0 ± 2.4 mm in the control group.



Our study showed no association between treatment with aromatase inhibitors for five or less years and increased carotid intima-media thickness and higher prevalence of carotid stenosis or abdominal aortic aneurism. The lack of impact on these markers suggests that cardiovascular risk is not increased by treatment with aromatase inhibitors.
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Eva
E
Blondeaux
Department of Vascular and Endovascular Surgery U.O. Chirurgia vascolare ed endovascolare IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Debora
D
Musio
Department of Epidemiology, IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Paolo
P
Bruzzi
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.|Department of Medicine, BrEAST Data Centre, Institut Jules Bordet, l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
Matteo
M
Lambertini
Department of Vascular and Endovascular Surgery U.O. Chirurgia vascolare ed endovascolare IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Valerio
V
Gazzola
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Francesca
F
Poggio
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Stefania
S
Vecchio
S.S. Sviluppo di Terapie Innovative Relating to Department of Medical Oncology IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genova, Italy.
Alessia
A
Levaggi
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Alessia
A
D'Alonzo
Department of Vascular and Endovascular Surgery U.O. Chirurgia vascolare ed endovascolare IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Maria Cecilia
MC
Perfumo
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Claudia
C
Bighin
Department of Medical Oncology U.O. Oncologia Medica 2 IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Sara
S
Giraudi
Department of Vascular and Endovascular Surgery U.O. Chirurgia vascolare ed endovascolare IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.|Università degli studi di Genoa, Via Balbi 5, 16126, Genova, Italy.
Domenico
D
Palombo
S.S. Sviluppo di Terapie Innovative Relating to Department of Medical Oncology IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genova, Italy. lucia.delmastro@hsanmartino.it.
Lucia
L
Del Mastro
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012307:Risk Factors; D013997:Time Factors; D047368:Tumor Burden
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D015415:Biomarkers
Aromatase inhibitor; Breast cancer; Cardiovascular risk; Toxicity