{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:18:45Z","timestamp":1779916725713,"version":"3.53.1"},"reference-count":26,"publisher":"BMJ","issue":"22","funder":[{"name":"fondation recherche medicale"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2018,4,9]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>A prolonged QTc (LQT) is a surrogate for the risk of torsade de pointes (TdP). QTc interval duration is influenced by sex hormones: oestradiol prolongs and testosterone shortens QTc. Drugs used in the treatment of breast cancer have divergent effects on hormonal status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a disproportionality analysis using the European database of suspected adverse drug reaction (ADR) reports to evaluate the reporting OR (ROR \u03c7<jats:sup>2<\/jats:sup>) of LQT, TdP and ventricular arrhythmias associated with selective oestrogen receptor modulators (SERMs: tamoxifen and toremifene) as opposed to aromatase inhibitors (AIs: anastrozole, exemestane and letrozole). When the proportion of an ADR is greater in patients exposed to a drug (SERMs) compared with patients exposed to control drug (AIs), this suggests an association between the specific drug and the reaction and is a potential signal for safety. Clinical and demographic characterisation of patients with SERMs-induced LQT and ventricular arrhythmias was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>SERMs were associated with higher proportion of LQT reports versus AIs (26\/8318 vs 11\/14851, ROR: 4.2 (2.11\u20138.55), p&lt;0.001). SERMs were also associated with higher proportion of TdP and ventricular arrhythmia reports versus AIs (6\/8318 vs 2\/14851, ROR: 5.4 (1.29\u201326.15), p:0.02; 16\/8318 vs 12\/14851, ROR: 2.38 (1.15\u20134.94), p:0.02, respectively). Mortality was 38% in patients presenting ventricular arrhythmias associated with SERMs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SERMs are associated with more reports of drug-induced LQT, TdP and ventricular arrhythmias compared with AIs. This finding is consistent with oestradiol-like properties of SERMs on the heart as opposed to effects of oestrogen deprivation and testosterone increase induced by AIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT03259711\" ext-link-type=\"clintrialgov\">NCT03259711<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2017-312934","type":"journal-article","created":{"date-parts":[[2018,11,17]],"date-time":"2018-11-17T05:56:35Z","timestamp":1542434195000},"page":"1859-1863","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Increased long QT and torsade de pointes reporting on tamoxifen compared with aromatase inhibitors"],"prefix":"10.1136","volume":"104","clinical-trial-number":[{"clinical-trial-number":"nct03259711","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Virginie","family":"Grouthier","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Reproductive Medicine, Sorbonne Universit\u00e9s, AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Centre de R\u00e9f\u00e9rence des Maladies Endocriniennes Rares de la Croissance, Centre de R\u00e9f\u00e9rence des Pathologies Gyn\u00e9cologiques Rares, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedicte","family":"Lebrun-Vignes","sequence":"additional","affiliation":[{"name":"AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital Department of Pharmacology CIC-1421 Pharmacovigilance Unit INSERM UMR ICAN 1166 Sorbonne Universit\u00e9 UPMC, Univ Paris 06, Institute of CArdiometabolism and Nutrition (ICAN), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Glazer","sequence":"additional","affiliation":[{"name":"Cardio-oncology Program, Departments of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Touraine","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Reproductive Medicine, Sorbonne Universit\u00e9s, AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Centre de R\u00e9f\u00e9rence des Maladies Endocriniennes Rares de la Croissance, Centre de R\u00e9f\u00e9rence des Pathologies Gyn\u00e9cologiques Rares, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Funck-Brentano","sequence":"additional","affiliation":[{"name":"AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital Department of Pharmacology CIC-1421 Pharmacovigilance Unit INSERM UMR ICAN 1166 Sorbonne Universit\u00e9 UPMC, Univ Paris 06, Institute of CArdiometabolism and Nutrition (ICAN), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Pariente","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Team Pharmaco-Epidemiology, CHU de Bordeaux, INSERM, CIC-1401, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carine","family":"Courtillot","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Reproductive Medicine, Sorbonne Universit\u00e9s, AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Centre de R\u00e9f\u00e9rence des Maladies Endocriniennes Rares de la Croissance, Centre de R\u00e9f\u00e9rence des Pathologies Gyn\u00e9cologiques Rares, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Bachelot","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Reproductive Medicine, Sorbonne Universit\u00e9s, AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Centre de R\u00e9f\u00e9rence des Maladies Endocriniennes Rares de la Croissance, Centre de R\u00e9f\u00e9rence des Pathologies Gyn\u00e9cologiques Rares, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan M","family":"Roden","sequence":"additional","affiliation":[{"name":"Cardio-oncology Program, Departments of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javid J","family":"Moslehi","sequence":"additional","affiliation":[{"name":"Cardio-oncology Program, Departments of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, 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Hypogonadism as a reversible cause of Torsade de Pointes in men. Circulation. 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The clinical significance of QT prolongation associated with tamoxifen: A review of the literature. 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