Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2000-7-31
pubmed:abstractText
Hormone replacement therapy (HRT) has been shown to increase the relative risk of idiopathic venous thromboembolism (VTE) about threefold in several observational studies and one randomised controlled trial. Whether or not this relative risk is higher in women with underlying thrombophilia phenotypes, such as activated protein C (APC) resistance, is unknown. We therefore restudied the participants in a case-control study of the relationship between the use of HRT and the occurrence of idiopathic VTE in women aged 45-64 years. After protocol exclusions, 66 of the cases in the original study and 163 of the controls were studied. Twenty haematological variables relevant to risk of VTE were analysed, including thrombotic states defined from the literature. The relative risk of VTE showed significant associations with APC resistance (OR 4.06; 95% CI 1.62, 10.21); low antithrombin (3.33; 1.15, 9.65) or protein C (2.93; 1.06, 8.14); and high coagulation factor IX (2.34; 1.26, 4.35), or fibrin D-dimer (3.84; 1.99, 7.42). HRT use increased the risk of VTE in women without any of these thrombotic states (OR 4.09; 95% CI 1.26, 13.30). A similar effect of HRT use on the relative risk of VTE was also found in women with prothrombotic states. Thus for example, the combination of HRT use and APC resistance increased the risk of VTE about 13-fold compared with women of similar age without either APC resistance or HRT use (OR 13.27; 95% CI 4.30, 40.97). We conclude that the combination of HRT use and thrombophilias (especially if multiple) increases the relative risk of VTE substantially; hence women known to have thrombophilias (especially if multiple) should be counselled about this increased risk prior to prescription of HRT. However, HRT increases the risk of VTE about fourfold even in women without any thrombotic abnormalities: possible causes are discussed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0340-6245
pubmed:author
pubmed:issnType
Print
pubmed:volume
83
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
530-5
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:10780311-Activated Protein C Resistance, pubmed-meshheading:10780311-Antithrombin III Deficiency, pubmed-meshheading:10780311-Case-Control Studies, pubmed-meshheading:10780311-Cohort Studies, pubmed-meshheading:10780311-England, pubmed-meshheading:10780311-Factor IX, pubmed-meshheading:10780311-Female, pubmed-meshheading:10780311-Fibrin Fibrinogen Degradation Products, pubmed-meshheading:10780311-Follow-Up Studies, pubmed-meshheading:10780311-Hormone Replacement Therapy, pubmed-meshheading:10780311-Humans, pubmed-meshheading:10780311-Middle Aged, pubmed-meshheading:10780311-Models, Biological, pubmed-meshheading:10780311-Odds Ratio, pubmed-meshheading:10780311-Partial Thromboplastin Time, pubmed-meshheading:10780311-Postmenopause, pubmed-meshheading:10780311-Prothrombin Time, pubmed-meshheading:10780311-Risk, pubmed-meshheading:10780311-Thromboembolism, pubmed-meshheading:10780311-Thrombophilia, pubmed-meshheading:10780311-Venous Thrombosis
pubmed:year
2000
pubmed:articleTitle
Thrombotic variables and risk of idiopathic venous thromboembolism in women aged 45-64 years. Relationships to hormone replacement therapy.
pubmed:affiliation
University Department of Medicine, Royal Infirmary, Glasgow, UK. gdl1j@clinmed.gla.ac.uk
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't