THE EFFECT OF TAMOXIFEN ON LIPID AND HEMOSTATIC PREDICTORS OF ISCHEMIC-HEART-DISEASE

The non-steroidal anti-oestrogen drug, tamoxifen, has been widely used in the palliative and adjuvant treatment of carcinoma of the breast I ts use as a prophylactic agent for this malignancy is still unclear. A s it is a drug of long-term use, its effects on other systems are impo rtant. This review looks at the effect of tamoxifen on lipids and haem ostatic factors associated with increased risk of ischaemic heart dise ase (IHD). Tamoxifen causes a fall in total cholesterol and low densit y lipoprotein concentrations in both pre- and post-menopausal women an d in this respect would decrease the risk of IHD. The effect on trigly cerides is minimal except in susceptible subjects where an elevation c on occur. Of interest is the consistent fall in serum lipoprotein (a) concentration which is thought to be an independent risk factor for IH D. There may well be a specific use for tamoxifen in this indication a part from its anticancer role. Fibrinogen appears to be unaffected by tamoxifen but falls in antithrombin III and protein C have been report ed. Overall, there is evidence of a decreased risk of IHD among long-t erm users of tamoxifen.