Risk of cardiovascular disease in breast cancer patients receiving aromatase inhibitors vs. tamoxifen: A systematic review and meta-analysis.

WHAT IS KNOWN AND OBJECTIVE: Breast cancer is one of the leading causes of morbidity and mortality in women worldwide. In order to reduce the risks of its recurrence, endocrine therapies, such as tamoxifen and aromatase inhibitors are commonly administered. Despite having a similar efficacy in preventing breast cancer recurrence, these drugs differ in terms of instigating cardiovascular morbidities. Recent randomized controlled trials and cohort studies provide inconclusive evidence of the cardiovascular risks associated with the administration of these endocrine therapies. This present review and meta-analysis evaluates the comparative cardiovascular adverse event outcomes in breast cancer patients receiving tamoxifen and aromatase inhibitors. To evaluate the comparative cardiovascular adverse outcomes, such as venous thromboembolism, heart failure, angina, myocardial infarction and stroke in patients with breast cancer receiving tamoxifen and aromatase inhibitors. METHODS: A systematic search of the academic literature was performed according to the PRISMA guidelines across five databases, including Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to compare the cardiovascular adverse events (i.e. venous thromboembolism, heart failure, angina, myocardial infarction, stroke) in breast cancer patients treated with tamoxifen and aromatase inhibitors. RESULTS AND DISCUSSION: From 993 studies, 20 eligible studies were identified, with 174,142 female breast cancer patients (mean age: 67.4 ± 3.8 years). A meta-analysis revealed insignificantly (p > 0.05) higher risks of venous thromboembolism (Odds ratio, 95% CI: 1.70, 0.91-3.18) in patients treated with tamoxifen as compared to aromatase inhibitors. We also observed insignificantly higher risks of stroke (0.93, 0.45-1.91), angina (0.77, 0.12-4.59), myocardial infarction (0.74, 0.30-1.79), and heart failure (0.81, 0.22-2.91) in patients receiving aromatase inhibitors as compared to tamoxifen. WHAT IS NEW AND CONCLUSIONS: The study provides evidence regarding the comparative cardiovascular adverse outcomes between breast cancer patients consuming tamoxifen and aromatase inhibitors. The study reports an insignificant increase in the events of stroke, angina, myocardial infarction, and heart failure in breast cancer patients treated with aromatase inhibitors as compared to tamoxifen. The study also reports that tamoxifen treatment is associated with an insignificant increase in the events of venous thromboembolism as compared to treatment with aromatase inhibitors.

Construction of Mn-Zn binary carbonate microspheres on interconnected rGO networks: creating an atomic-scale bimetallic synergy for enhancing lithium storage properties.

Transition metal carbonates (TMCs), as promising anode materials for high-performance lithium ion batteries, possess the advantages of abundant natural resources and high electrochemical activity; however, they suffer from poor Li+/e- conductivities and serious volume changes during the charge/discharge process. Constructing multicomponent carbonates by introducing binary metal atoms, as well as designing a robust structure at the micro and nanoscales, could efficiently address the above problems. Therefore, single-phase MnxZn1-xCO3 microspheres anchored on 3D conductive networks of reduced graphene oxide (rGO) are facilely synthesized via a one-pot hydrothermal method without any structure-directing agents or surfactants. Due to the well-designed architecture and atomic-scale bimetallic synergy, the MnxZn1-xCO3/rGO composites show superior lithium storage capacity, good rate capability and ultra-long cycling performance. Specifically, the Mn2/3Zn1/3CO3/rGO composites could deliver a high capacity of 1073 mA h g-1 at 200 mA g-1. After 1700 cycles at a high rate of 2000 mA g-1, a stable capacity of 550 mA h g-1 can be maintained with the capacity retention approaching 88.6%. Density functional theory (DFT) calculations indicate that the partial Zn substitution in MnCO3 could significantly decrease the band gap of the crystal, resulting in great improvement of electric conductivity. Moreover, the commercial potential of the MnxZn1-xCO3/rGO composites is investigated by assembling full cells, suggesting good practical adaptability of the composite anodes. This work would provide a feasible and cost-efficient method to develop high-performance anodes and stimulate many more related research studies on TMC-based electrodes.