Atherosclerotic disease and cardiovascular risk factors in postmenopausal breast cancer survivors: a case–control study

Abstract

Objective: Breast cancer (BC) therapies and the longevity that the women achieve imply a higher cardiovascular risk. The aim of the study was to evaluate the frequency of atherosclerotic disease and its association with cardiovascular risk factors in postmenopausal breast cancer survivors (BCS) compared to postmenopausal women without BC.

Methods: In this study, 96 women with BC (case group) were compared to 192 women without BC (control group), age range 45–75 years. The case group included women with a histological diagnosis of BC, amenorrhea ≥ 12 months, and age ≥ 45 years, without metastatic disease or cardiovascular disease (CVD). The control group consisted of women with amenorrhea ≥ 12 months and age ≥ 45 years, without BC or CVD. Total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, and insulin were measured. Atherosclerotic disease was determined by increased intima-media thickness (thickness > 1.0 mm) of the carotid arteries and/or presence of atheromatous plaques evaluated by carotid duplex ultrasound.

Results: The frequency of diabetes and metabolic syndrome were higher in BCS compared to controls (19.8% vs. 6.8% and 54.2% vs. 37.0%, respectively, p < 0.05). There was no difference in subclinical atherosclerosis between groups (BCS 26% vs. controls 18.7%, p = 0.062). However, atheromatous plaques were more frequent in BCS compared to controls (19.8% vs. 9.4%, p = 0.013). In the risk analysis, adjusted for age, time since menopause, and body mass index, BCS had a 2.4-fold higher risk of atheromatous plaques (odds ratio = 2.42; 95% confidence interval 1.18–4.93, p = 0.033) than women without BC.

Conclusion: Postmenopausal BCS had a higher risk of developing atherosclerotic disease, associated with a higher frequency of cardiovascular risk factors such as metabolic syndrome and diabetes, when compared to women of the same age group without BC.

摘要

目的: 乳腺癌(BC)的治疗和女性较高的生存率意味着心血管风险的增高。本研究的目的是比较绝经后乳腺癌幸存者(BCS)及未患BC女性动脉粥样硬化疾病的发生率及其与心血管危险因素的差异。 方法：将年龄45-75岁的96例BC患者(病例组)与192例无BC患者(对照组)进行比较。 病例组入组标准为存在女性乳腺癌的组织学诊断, 闭经≥12个月, 年龄≥45岁, 未出现远处转移或心血管疾病(CVD)。对照组入选标准为闭经≥12个月, 年龄≥45岁, 无BC或心血管疾病。检测两组的总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、葡萄糖和胰岛素指标。动脉粥样硬化疾病诊断标准为颈动脉内膜厚度增加(厚度> 1.0mm)和/或颈动脉双相超声评估存在动脉粥样斑块。结果：BCS组糖尿病和代谢综合征发生率高于对照组(19.8%比6.8%, 54.2%比37.0%, p<0.05)。亚临床动脉粥样硬化发病率在两组之间没有明显差别 (BCS 26%比18.7%,p = 0.062)。然而, BCS相比对照组粥样斑块的发生更频繁(19.8%比9.4%, p = 0.013)。在风险分析中, 校正年龄、绝经期, 体质指数后, BCS粥样斑块发生的概率比对照组要高2.4倍 (比值比= 2.42; 95%置信区间为1.18 -4.93, p = 0.033)。 结论：绝经后BCS发生动脉粥样硬化性疾病的风险较高, 且代谢综合征、糖尿病等心血管危险因素发生的频率较高。

Keywords:

• Breast cancer
• atherosclerotic disease
• cardiovascular risk
• menopause

Conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

Nil.