© 2005 Oxford University Press
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Coronary Heart Disease Mortality After 5 Years of Adjuvant Tamoxifen Therapy: Results from a Randomized Trial
Affiliations of authors: Department of Oncology, Linköping University Hospital, Linköping, Sweden (BN, JR); Department of Oncology, Södersjukhuset Hospital, Stockholm, Sweden (L-ER); Department of Oncology, Lund University Hospital, Lund, Sweden (P-OM); Department of Oncology, Karolinska Hospital, Stockholm, Sweden (JB, TH); Department of Oncology, Umeå University Hospital, Umeå, Sweden (N-OB); Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden (AW); Department of Health and Society, Linköping University, Linköping, Sweden (JC)
Correspondence to: Bo Nordenskjöld, MD, PhD, Department of Oncology, Linköping University Hospital, S-581 85 Linköping, Sweden (e-mail: bo.nordenskjold{at}lio.se).
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.
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