Impact of Aromatase Inhibitors Treatment Duration on Coronary Artery Calcification in Postoperative Patients With Breast Cancer

Aromatase inhibitors (AIs) are the standard therapeutic approach for hormone receptor–positive postmenopausal breast cancer. However, there are concerns about increased cardiovascular risk due to their antioestrogenic effects. This study aimed to investigate the potential association between duration of AI treatment and the severity of coronary artery calcification (CAC). The study included outpatients who initiated adjuvant endocrine therapy with AIs for breast cancer from August 2010 to October 2022. CAC was quantified according to a visual ordinal scoring system. Patient characteristics were assessed based on the presence of CAC. Independent risk factors for elevated CAC scores were identified through a multivariable logistic regression model. Among 357 patients, 44.8% exhibited CAC. No significant difference in AI treatment duration was observed between groups (1268 d [interquartile range (IQR) 725-1743 d] vs 1104 d [IQR 685-1683.25 d]; P = 0.236). Patients with CAC were characterised by higher age (63.06 y [56.81-68.78 y] vs 74.39 y [68.98-80.03 y]; P < 0.001), lower hemoglobin levels (g/dL: 13.20L [IQR 12.60-13.70L] vs 12.60 [IQR 11.60-13.43]; P < 0.001), and reduced estimated glomerular filtration rate (mL/min/1.73 m2: 72.00 [IQR 61.80-81.50] vs 62.80 [IQR 51.27-71.90]; P < 0.001) compared with those without CAC. The prevalences of hypertension, diabetes mellitus, and dyslipidemia were significantly higher in patients with CAC. No correlation was found between the duration of AI treatment and CAC score (R = −0.02; P = 0.78). Independent risk factors for CAC included higher age, lower hemoglobin levels, and the presence of hypertension and diabetes mellitus in postoperative patients with breast cancer. The duration of AI treatment does not exert a significant influence on CAC in postoperative patients with breast cancer. Les inhibiteurs de l'aromatase (IA) constituent l'approche thérapeutique standard pour le cancer du sein post-ménopausique positif aux récepteurs hormonaux. Cependant, il existe des préoccupations quant à l'augmentation du risque cardiovasculaire due à leurs effets antiœstrogéniques. Cette étude visait à étudier l'association potentielle entre la durée du traitement par les IA et la sévérité de la calcification des artères coronaires (CAC). L'étude a porté sur des patientes vues en ambulatoire, qui ont commencé un traitement endocrinien adjuvant avec des IA pour un cancer du sein entre août 2010 et octobre 2022. La CAC a été quantifi