Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
THE RISK OF MYOCARDIAL-INFARCTION ASSOCIATED WITH THE COMBINED USE OFESTROGENS AND PROGESTINS IN POSTMENOPAUSAL WOMEN
Autore:
PSATY BM; HECKBERT SR; ATKINS D; LEMAITRE R; KOEPSELL TD; WAHL PW; SISCOVICK DS; WAGNER EH;
Indirizzi:
UNIV WASHINGTON,DEPT MED,CARDIOVASC HLTH RES UNIT,METROPOLITAN PK 2 BLDG,SUITE 1360 SEATTLE WA 98101 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98195 UNIV WASHINGTON,DEPT BIOSTAT SEATTLE WA 98195 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98195 CTR HLTH STUDIES,GRP HLTH COOPERAT PUGET SOUND SEATTLE WA 00000
Titolo Testata:
Archives of internal medicine
fascicolo: 12, volume: 154, anno: 1994,
pagine: 1333 - 1339
SICI:
0003-9926(1994)154:12<1333:TROMAW>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; REPLACEMENT THERAPY; HORMONAL REPLACEMENT; LIPOPROTEINS; PREVENTION; CARCINOMA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
22
Recensione:
Indirizzi per estratti:
Citazione:
B.M. Psaty et al., "THE RISK OF MYOCARDIAL-INFARCTION ASSOCIATED WITH THE COMBINED USE OFESTROGENS AND PROGESTINS IN POSTMENOPAUSAL WOMEN", Archives of internal medicine, 154(12), 1994, pp. 1333-1339

Abstract

Background: While observational studies have suggested that unopposedestrogens reduce the incidence of coronary disease in postmenopausal women, there are few data on the effect of combined therapy with estrogens and progestins-a regimen adopted in recent years to minimize the risk of endometrial hyperplasia and cancer. In clinical trials, the addition of progestins has an adverse effect on serum lipid levels, and these lipid effects have raised the question of whether combined estrogen-progestin therapy increases the risk of coronary disease compared with the use of estrogen alone. Methods: We conducted a population-based, case-control study among enrollees of Group Health Cooperative of Puget Sound. Cases were postmenopausal women who sustained an incidentfatal or nonfatal myocardial infarction in 1986 through 1990. Controls were a stratified random sample of female Group Health Cooperative enrollees frequency matched to the cases by age and calendar year. We reviewed the medical records of the 502 cases and 1193 controls and conducted brief telephone interviews with consenting survivors. The health maintenance organization's computerized pharmacy database was used to ascertain the use of postmenopausal hormones. For the primary analysis of current use, we classified women into one of three groups: (1) nonusers of hormones; (2) users of estrogens alone; or (3) users of combined therapy including both estrogens and progestins. Each group of hormone users was compared with nonusers. Results: After adjustment forpotential confounding factors, the risk ratio of myocardial infarction associated with current use of estrogens alone was 0.69 (95% confidence interval, 0.47 to 1.02); and the risk ratio of myocardial infarction associated with current use of combined therapy was 0.68 (95% confidence interval, 0.38 to 1.22). Duration of combined-therapy use was relatively short, averaging less than 2 years in cases and controls. Conclusions: In this case-control study, the reduced risk of myocardial infarction associated with the use of estrogens alone was consistent with previous observational studies. Although the 95% confidence interval only excluded a risk above 1.22, the current use of combined therapywas not associated with an adverse effect on the incidence of myocardial infarction in postmenopausal women.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 18:26:33