Tamoxifen (Nolvadex) & Men with Heart Disease

Importance of the study: The same drug that treats and helps reduce the risk of breast cancer in women may help unclog arteries in men, possibly leading to a lower risk of heart attack.

Study description: Thirty-one men with coronary artery disease participated in this 56-day study conducted at Papworth Hospital in Cambridge, England. Fifteen received no tamixofen (Nolvadex) treatment, while the other 16 received 40 milligrams a day of tamoxifen (twice the daily dose women take to treat breast cancer).

All 31 men received aspirin and another drug known to reduce blockages in the arteries. Another 10 men who had angina-like symptoms (chest pain due to insufficient oxygen to the heart muscle), but normal coronary arteries, also received tamoxifen but no other treatment.

Study results: A special ultrasound technique was used to measure blood flow in the forearms of the men in the study. The arteries of the men who took tamoxifen expanded to accommodate more blood flow than the arteries of those who didn’t receive the drug.

This suggests that tamoxifen reduced the buildup of cholesterol (plaque) and reduced the arteries’ rigidity, both risk factors for heart attacks. In fact, the arteries of those who took tamoxifen resembled those of a younger person with no coronary artery disease The men taking tamoxifen also showed lower levels of cholesterol, triglycerides (a type of fat in the blood), lipoprotein(a) (a special fat-protein combination), and fibrinogen (a blood-clotting substance) —all additional risk factors for heart disease.

These tamoxifen benefits went beyond those seen in the men who took only the cholesterol-lowering drug. Take-home message: While this study was very preliminary and small, the results suggest that tamoxifen—and perhaps other drugs within the same family—may help reduce the risk of heart disease. Tamoxifen belongs to a class of drugs known as SERMs, selective estrogen receptor modulators, which mimic the actions of estrogen in some tissues of the body.

Anastrazole in Men (abstract only)

Am J Clinical Oncology, 6/02

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