Myocardial Infarction Risk for Women with Breast Cancer: Annotated Bibliography Abdel-Qadir, H., Amir, E., Fischer, H. D., Fu, L., Austin, P. C., Harvey, P. J., ... & Anderson, G. M. (2016). The risk of myocardial infarction with aromatase inhibitors relative to tamoxifen in post-menopausal women with early stage breast cancer. European Journal of Cancer, 68, 11-21.

The rationale for this study was that a gap in the literature existed with respect to the possibility of aromatase inhibitors increasing cardiovascular risk relative to tamoxifen among breast cancer patients who were in the post-menopause phase of life. The participants consisted of more 9500 women over the age of 55 suffering from breast cancer (stage 1 to 3) in Ontario, Canada. The researchers conducted an observational cohort study to observe the myocardial infarction risk of aromatase inhibitors and tamoxifen. They examined cases of hospitalization of the population sampled as a result of myocardial infarction and compared cases of those being treated with aromatase inhibitors to those being treated with tamoxifen.

The researchers found that aromatase inhibitors were associated with higher risk of myocardial infarction compared to risk associated with tamoxifen. The implications for clinical practice are that nurses and physicians should consider restricting treatment of breast cancer in post-menopausal women to tamoxifen and not use aromatase inhibitors such as Arimidex, Aromasin or Femara as these can raise the risk of myocardial infarction. Reduction of aromatase inhibitors could help to lower the rate of hospitalization for myocardial infarction for this particular population as well.

Cheng, Y. J., Nie, X. Y., Ji, C. C., Lin, X. X., Liu, L. J., Chen, X. M., ... & Wu, S. H. (2017). Long?Term Cardiovascular Risk After Radiotherapy in Women With Breast Cancer. Journal of the American Heart Association, 6(5), e005633.

The rationale for this study was to obtain quantitative data that...

The researchers wanted to fill a gap in the literature pertaining to quantified data on heart disease risk and ionizing radiation. No experiment or test was conducted and no participants were used in this study. Instead, the researchers conducted a systematic literature review and meta-analysis. The researchers examined 39 studies and obtained their data from there, looking at studies that focused on radiotherapy and that included information about the effects of this intervention on the heart. They summarized the statistical evidence accumulated through this review, identifying what all the different studies found.
The researchers found that the evidence as reported in the literature review indicated a strong association between radiotherapy and the risk of heart disease. According to the studies reviewed, patients who received radiotherapy were statistically more at risk of developing heart disease than patients who did not. The implications for practice are that physicians should consider the risk/reward ratio when it comes to using radiotherapy as an intervention for treating breast cancer. It may help to defeat the cancer but it can have long-term negative side effects on the condition of the heart. These side effects can include an increased risk for coronary heart disease and cardiac death. To ensure the total safety of the patient, alternatives to radiotherapy should be considered, and patients should be educated about the risks that come with the radiotherapy intervention.

Darby, S. C., Ewertz, M., McGale, P., Bennet, A. M., Blom-Goldman, U., Brønnum, D.,... & Jensen, M. B. (2013). Risk of ischemic heart disease in women after radiotherapy for breast cancer. New England Journal of Medicine, 368(11), 987-998.

The rationale for this study was that uncertainty existed about whether radiation in the treatment of breast cancer…