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In postmenopausal women, aromatase predictive of CVD mortality

Issue: January 2011

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American Heart Association Scientific Sessions 2010

CHICAGO — An indirect method of measuring aromatase activity in postmenopausal women may also aid in the assessment of 25-year risk for CVD mortality, according to an analysis of participants in the Rancho Bernardo study.

The study researchers examined 817 non-estrogen-treated postmenopausal women aged 50 to 90 years who were enrolled in the Rancho Bernardo study between 1984 and 1987. The participants were then followed for 25 years. They then examined aromatase activity by use of the aromatase activity index, defined as the ratio of serum estrone to androstenedione.

A total of 247 deaths were attributed to CVD, according to the study results. The aromatase index was positively associated with age, BMI and waist-to-hip ratio (P<.01 for all relationships). Following adjustment for age, adiposity and lifestyle, proportional hazards regression analysis suggested that CVD mortality was higher in women in the lowest (P=.002) and highest (P=.043) quintiles of aromatase index compared with the middle quintiles.

Serum estrone and androstenedione levels alone were not predictive of CVD mortality, and aromatase index was not related to non-CVD death.

“These findings suggest that aromatase may be a novel endocrine factor that is predictive of CV mortality among postmenopausal women, but additional studies are needed to determine whether the association of aromatase with CV death reflects genetic influences or perhaps some underlying disease influences that we did not test,” Gail A. Laughlin, PhD, assistant adjunct professor of medicine at the University of California San Diego Medical Center in La Jolla, said in her presentation. “If confirmed, these results raise concerns about the long-term CV health of a large number of breast cancer patients who are now being treated with aromatase inhibitors.”

Laughlin reports no relevant disclosures. – by Eric Raible

For more information:

• Laughlin G. Abstract 13804. Presented at: American Heart Association Scientific Sessions 2010; Nov. 13-17; Chicago.

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