Tamoxifen and cardiac risk factors in healthy women - Suggestion of an anti-inflammatory effect

Tamoxifen reduces the incidence of breast cancer in women at risk for that disease. Because heart disease is the leading cause of death in women and b ecause tamoxifen is also associated with venous thrombosis, an improved und erstanding of the association of tamoxifen with cardiovascular disease risk factors is required. In III healthy women at a single center, who were par ticipating in a randomized double-blind breast cancer prevention trial, the 6-month effects of oral tamoxifen (20 mg/d) compared with placebo on facto rs related to inflammation, hemostasis, and lipids were studied. Tamoxifen was associated with reductions of 26% in median C-reactive protein, 22% in median fibrinogen, and 9% in cholesterol (all P<0.01 compared with placebo) . There were no differences in treatment effects on factor VII coagulant ac tivity, fragment 1-2, and triglycerides. In secondary analyses, the effect of tamoxifen on C-reactive protein was larger in postmenopausal women and i n women with higher waist-to-hip ratios. The effect on fibrinogen was large r in women with higher baseline cholesterol. Tamoxifen demonstrated effects on inflammatory markers that were consistent with reduced cardiovascular r isk. These findings are in contrast to recent reports of increased C-reacti ve protein associated with postmenopausal estrogen. The potential for benef icial cardiovascular effects of tamoxifen in healthy women is suggested.