Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 120, Issue 1, Pages 109-116Publisher
WILEY
DOI: 10.1046/j.1365-2141.2003.03976.x
Keywords
tamoxifen; venous thromboembolism; blood coagulation; risk factor; breast cancer
Categories
Funding
- NATIONAL CANCER INSTITUTE [F32CA007377] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [K08HL003618] Funding Source: NIH RePORTER
- NCI NIH HHS [U10-CA-699974, U10-CA-7377] Funding Source: Medline
- NHLBI NIH HHS [HL03618] Funding Source: Medline
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Tamoxifen reduces breast cancer incidence among healthy women, but is associated with an increased risk of venous thrombosis. We studied the 6 month effects of tamoxifen on venous thrombosis risk factors in women without cancer. One hundred and eleven women at one centre who were participants in a multicentre breast cancer prevention trial were randomized, in double-blind fashion, to receive 20 mg/d of tamoxifen or placebo. The activated protein C (APC) ratio and concentrations of antithrombin, protein C antigen, and total protein S were measured at baseline and 6 months of treatment. None of the factors changed over 6 months in placebo-treated women. Among tamoxifen-treated women, antithrombin and protein S, but not protein C or APC ratio were reduced. Sequential antithrombin concentrations with tamoxifen were 114% and 104% (P = 0.001 compared with placebo). Sequential protein S concentrations with tamoxifen were 18.42 and 17.30 mug/ml (P = 0.02 compared with placebo). Reductions in antithrombin and protein S were greater in postmenopausal women, but did not differ by other risk factors for venous thrombosis, such as body mass index. Reductions of antithrombin and protein S, but not protein C or APC resistance, might relate to the increased risk of venous thrombosis associated with tamoxifen treatment.
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