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02 vs 35.19 per 1000 person-years, HR 0.74, 95% 0.60 to 0.92; age-standardised incidence rate AI vs unexposed 36.82 vs 35.19, HR 0.96, 95% CI 0.83 to 1.1. Similar patterns were seen for other cardiovascular outcomes (arrhythmia, heart failure and valvular heart disease). As expected, there was more venous thromboembolism in tamoxifen compared with both AI users and those unexposed. Higher risks of several cardiovascular outcomes among AI compared with tamoxifen users appeared to be driven by protective effects of tamoxifen, rather than

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