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Thromb Haemost 2011; 106(01): 149-155
DOI: 10.1160/TH10-12-0778
Cellular Proteolysis and Oncology
Schattauer GmbH

Myocardial infarction, ischaemic stroke and pulmonary embolism before and after breast cancer hospitalisation

A population-based study
Myrthe P. P. van Herk-Sukel
1   PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
,
Sumitra Shantakumar
2   GlaxoSmithKline, Oncology Biometrics and Epidemiology, Research & Development, RTP, North Carolina, USA
,
Pieter W. Kamphuisen
3   Department of Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands
,
Fernie J. A. Penning-van Beest
1   PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
,
Ron M. C. Herings
1   PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
4   Department of Health Policy & Management, Erasmus University Medical Centre, Rotterdam, the Netherlands
› Institutsangaben Financial support: This study was supported by GlaxoSmithKline, RTP, NC, USA.
Weitere Informationen

Publikationsverlauf

Received: 07. Dezember 2010

Accepted after major revision: 25. März 2011

Publikationsdatum:
24. November 2017 (online)

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Summary

We studied the occurrence of myocardial infarction (MI), ischaemic stroke (IS) and pulmonary embolism (PE) before and after breast cancer hospitalisation compared with cancer-free controls. For this, women with a first breast cancer hospitalisation during 2000–2007 were selected from the PHARMO Record Linkage System, including drug use and hospitalisations of three million inhabitants in the Netherlands, and matched 1:10 by age to cancer-free women. The occurrence of MI, IS and PE were assessed in the 12 months before and after breast cancer hospitalisation. The study included 11,473 breast cancer patients, with a mean (± SD) age of 59 (± 14) years. Breast cancer patients were two to three times as likely as their cancer-free controls to have had a hospitalisation for PE, MI or IS in the 12 months before diagnosis, though prevalence was <1% in all groups. Breast cancer patients experienced an extreme high risk of PE in the first six months after diag- nosis (hazard ratio [HR] 23.5, 95% confidence interval [CI] 11.1–49.7 compared to controls), which declined gradually to a four times increased risk (HR 3.6, 95%CI 2.4–5.5) more than 12 months after breast cancer hospitalisation. However, incidence was low: less than five events per 1,000 person years during all time periods. For MI and IS we did not observe significant increased HRs after breast cancer hospitalisation compared to controls. Breast cancer patients seem to have a higher risk profile to develop MI and IS, and receive treatment that increases the risk of PE compared to cancer-free controls, although the frequency of hospitalisations was low.

Keywords

Breast cancer - incidence - ischaemic stroke - myocardial infarction - pulmonary embolism - risk factors
 

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