Coronary heart disease mortality and adjuvant tamoxifen therapy.
Coronary heart disease mortality and adjuvant tamoxifen therapy.
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冠心病死亡率和他莫昔芬辅助治疗。
DOI：
10.1093/jnci/89.11.776
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Dignam,J
中科院分区：
文献类型：
--
作者：
Costantino,JP;Kuller,LH;Ives,DG;Fisher,B;Dignam,J
背景和目的：来自苏格兰和瑞典的随机临床试验的数据表明，他莫昔芬治疗乳腺癌患者的疗效表明，该药物也可能降低冠心病的风险。鉴于这些研究结果，我们研究了冠状动脉心脏病的死亡率与早期乳腺癌患者谁是在国家外科辅助乳腺和肠道项目B-14试验他莫昔芬therapy.Methods：死亡发生在妇女谁被随机分配到5年的他莫昔芬或安慰剂在第一阶段的B-14试验进行了审查，以确定原因。定义了3类心脏病相关死亡：1）明确致死性心肌梗死导致的死亡，2）明确致死性冠心病/可能心肌梗死导致的死亡，3）可能致死性冠心病导致的死亡。根据平均年危害（即，结果：接受他莫昔芬治疗的患者冠心病的年平均死亡率低于接受安慰剂治疗的患者，但差异无统计学意义。有8例明确的心脏相关死亡（即，在接受他莫昔芬治疗的患者中，明确的致死性心肌梗死或明确的致死性冠心病/可能的心肌梗死），平均年发生率为0.62/1000例患者。在接受安慰剂的患者中，有12例明确的心脏相关死亡，平均年死亡率为0.94/1000。明确的致命性心脏病（他莫昔芬与安慰剂）死亡的相应相对危险度为0.66（95%置信区间= 0.27- 1.61）。他莫昔芬组的11例死亡和安慰剂组的10例死亡被归类为可能的致死性冠心病病例。当这些病例和确诊病例一起考虑时，接受他莫昔芬治疗的患者的平均年死亡率为1.48/1000，接受安慰剂治疗的患者为1.73/1000。相应的死亡相对危险度为0.85（95%置信区间= 0.46-1.58）。结论：从B-14试验的结果是一致的，从苏格兰和瑞典的试验结果，表明他莫昔芬治疗减少乳腺癌患者的冠心病。需要对这些试验和正在进行的预防试验中的患者进行持续随访，以积累足够的数据，从而得出关于他莫昔芬预防心脏病益处的可靠结论。
Background and Purpose:Data from randomized clinical trials in Scotland and Sweden testing the efficacy of tamoxifen therapy in patients with breast cancer have suggested that the drug may also reduce the risk of coronary heart disease. In view of these findings, we examined mortality from coronary heart disease among patients with early stage breast cancer who were enrolled in the National Surgical Adjuvant Breast and Bowel Project B-14 trial of tamoxifen therapy.Methods:Deaths occurring among women who were randomly assigned to 5 years of either tamoxifen or placebo in the first phase of the B-14 trial were reviewed to determine the cause. Three categories of heart disease-related death were defined: 1) death from a definite fatal myocardial infarction, 2) death from definite fatal coronary heart disease/ possible myocardial infarction, and 3) death from possible fatal coronary heart disease. Comparisons of the findings by treatment group were made on the basis of average annual hazard (i.e., death) rates and the corresponding relative hazard of death.Results:The average annual death rate from coronary heart disease was lower for patients who received tamoxifen than for patients who received placebo, but the difference was not statistically significant. There were eight definite heart-related deaths (i.e., definite fatal myocardial infarction or definite fatal coronary heart disease/possible myocardial infarction) among the patients who received tamoxifen, yielding an average annual rate of 0.62 per 1000 patients. There were 12 definite heart-related deaths among the patients who received placebo, yielding an average annual rate of 0.94 per 1000. The corresponding relative hazard of death from definite fatal heart disease (tamoxifen versus placebo) was 0.66 (95% confidence interval = 0.27- 1.61). Eleven deaths in the tamoxifen group and 10 deaths in the placebo group were classified as possible cases of fatal coronary heart disease. When these cases and the definite cases were considered together, the average annual death rate for the patients who received tamoxifen was 1.48 per 1000, and the rate for the patients who received placebo was 1.73 per 1000. The corresponding relative hazard of death was 0.85 (95% confidence interval = 0.46-1.58).Conclusions:The findings from the B-14 trial are consistent with the findings from the Scottish and the Swedish trials, suggesting that tamoxifen treatment reduces coronary heart disease among patients with breast cancer. Continued follow-up of the patients in these trials and in ongoing prevention trials is needed to accumulate enough data so that reliable conclusions can be drawn about the benefits of tamoxifen in preventing heart disease.
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他莫昔芬和4-羟基他莫昔芬对人类低密度脂蛋白氧化损伤的保护作用：他莫昔芬心脏保护作用的机制？
影响因子：
4.1
作者：
H. Wiseman;G. Paganga;C. Rice;B. Halliwell
通讯作者：
B. Halliwell
患有乳腺癌的绝经后妇女的他莫昔芬使用、雌激素结合和血清脂质。
DOI：
--
发表时间：
1990
期刊：
Australian and New Zealand Journal of Surgery
影响因子：
--
作者：
D. Ingram
通讯作者：
D. Ingram
用他莫昔芬预防乳腺癌——皇家马斯登医院试点计划的最新进展。
影响因子：
8.4
作者：
T. Powles;C. Tillyer;A. Jones;S. Ashley;J. Treleaven;J. Davey;J. Alan McKinna
通讯作者：
J. Alan McKinna
影响因子：
10.3
作者：
Fisher, B;Dignam, J;Lickley, HL
通讯作者：
Lickley, HL
影响因子：
158.5
作者：
FISHER, B;COSTANTINO, J;KETNER, M
通讯作者：
KETNER, M