Barish et al Breast Cancer and Cardiovascular Disease 43. Burstein HJ, Temin S, Anderson H, Buchholz TA, Davidson NE, Gelmon az-ca/downloads/productinformation/arimidex-product-monograph-en. KE, Giordano SH, Hudis CA, Rowden D, Solky AJ, Stearns V, Winer EP, pdf. Accessed December 11, 2018. Griggs JJ. Adjuvant endocrine therapy for women with hormone recep- 47. Khosrow-Khavar F, Filion KB, Al-Qurashi S, Torabi N, Bouganim N, Suissa tor-positive breast cancer: american society of clinical oncology clinical S, Azoulay L. Cardiotoxicity of aromatase inhibitors and tamoxifen in post- practice guideline focused update. J Clin Oncol. 2014;32:2255–2269. doi: menopausal women with breast cancer: a systematic review and meta- 10.1200/JCO.2013.54.2258 analysis of randomized controlled trials. Ann Oncol. 2017;28:487–496. 44. Amir E, Seruga B, Niraula S, Carlsson L, Ocaña A. Toxicity of adjuvant en- doi: 10.1093/annonc/mdw673 docrine therapy in postmenopausal breast cancer patients: a systematic 48. Haque R, Shi J, Schottinger JE, Chung J, Avila C, Amundsen B, Xu X, Barac review and meta-analysis. J Natl Cancer Inst. 2011;103:1299–1309. doi: A, Chlebowski RT. Cardiovascular Disease After Aromatase Inhibitor Use. STATE OF THE ART STATE 10.1093/jnci/djr242 JAMA Oncol. 2016;2:1590–1597. doi: 10.1001/jamaoncol.2016.0429 45. Buzdar A, Howell A, Cuzick J, Wale C, Distler W, Hoctin-Boes G, Hough- 49. Coates AS, Keshaviah A, Thürlimann B, Mouridsen H, Mauriac L, Forbes ton J, Locker GY and Nabholtz JM. Comprehensive side-effect pro- JF, Paridaens R, Castiglione-Gertsch M, Gelber RD, Colleoni M, Láng I, Del file of anastrozole and tamoxifen as adjuvant treatment for early-stage Mastro L, Smith I, Chirgwin J, Nogaret JM, Pienkowski T, Wardley A, Ja- breast cancer: long-term safety analysis of the ATAC trial. Lancet Oncol. kobsen EH, Price KN, Goldhirsch A. Five years of letrozole compared with 2006;7:633–643. tamoxifen as initial adjuvant therapy for postmenopausal women with 46. Arimidex. (anastrozole) [prescribing information]. Wilmington, DE: Astra- endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Zeneca Pharmaceuticals; 2014. https://www.astrazeneca.ca/content/dam/ Oncol. 2007;25:486–492. doi: 10.1200/JCO.2006.08.8617 Vienna General Hospital and the “Narrenturm” – “Fool’s Tower” Vienna General Hospital was established in 1784 by the order of Emperor Joseph II. The conceptual design of the hospital complex was modeled after the Hôtel-Dieu de Paris in France. Adjacent to the hospital was an orphanage, a maternity ward, and the first building worldwide for accommodating mentally ill patients, the so-called “Narrenturm“, or “Fool’s Tower”, constructed by Isidore Canevale. The cylindrical building consisted of 5 floors with a total of 139 rooms for approximately 200 to 250 psychiatric patients. Each patient cell was equipped with strong lattice doors and iron rings for chaining patients. However, only 10 years after its opening, the tower was obsolete because of innovations in therapeutic concepts for the mentally ill. The round form of the building complex is derived the colloquial denomination in Viennese dialect, “Gugelhupf”, meaning a round version of Austrian cake. Over the following centuries, up until the 1960s, duty rooms for nursing staff and doctors of the Vienna General Hospital were accommodated inside the tower (presumably the chains were removed). Today, the tower is home to the Federal Pathologic-Anatomical Museum of Vienna. In 1994, a new building complex was officially opened for the Vienna General Hospital, which currently employs 1600 physicians and 4500 allied health and nursing workers and is the main teaching hospital for 11 000 students of the Medical University of Vienna Michael Lichtenauer, MD, PhD University Hospital Salzburg, Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria 1120 February 19, 2019 Circulation. 2019;139:1110–1120. DOI: 10.1161/CIRCULATIONAHA.118.039371.