Changes in haemostatic variables induced by oral contraceptives containing 50 micrograms or 30 micrograms oestrogen: absence of dose-dependent effect on PAI-1 activity.
Several studies have suggested a dose-response relation between the oestrogen content of oral contraceptive (OC) and the risk of both venous thrombosis and arterial disease, when oestrogen doses were higher than 50 micrograms. However, there is no clear epidemiological evidence for a decrease in thrombotic risk with formulations containing less than 50 micrograms oestrogen. Therefore, we investigated haemostatic variables in users of OC containing either 30 micrograms (35 women) or 50 micrograms (29 women) ethinyl estradiol as compared with non users (64 women) matched for age and smoking status. Mean values of antithrombin activity were significantly lower in 30 micrograms or 50 micrograms oestrogen users than in non users (96% and 98% vs 105%, respectively, p < 0.001), but they were not significantly different between the two groups of OC users. There was a significant increase in mean values of factor VII antigen in women taking either 30 micrograms or 50 micrograms oestrogen as compared with non users (96% and 101% vs 85%, respectively, p < 0.005). Although the difference between both groups of OC users was not significant, a positive linear trend in factor VII levels was observed within the 0-50 micrograms oestrogen range (p < 0.001). Mean levels of fibrinogen were slightly higher in 30 micrograms or 50 micrograms oestrogen users than in non users (2.71, 2.66 g/l vs 2.55 g/l, respectively), but there was no significant difference between the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Scarabin
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INSERM, Cardiovascular Epidemiology Unit U 258, Hôpital Broussais, France.
Plu-Bureau
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Zitoun
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Bara
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Guize
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Samama
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D000328:Adult; D000941:Antigens / Q000097:blood; D000990:Antithrombin III / Q000378:metabolism; D016022:Case-Control Studies; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004967:Estrogens / Q000009:adverse effects*; D005167:Factor VII / Q000276:immunology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012307:Risk Factors
D000941:Antigens; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D004967:Estrogens; D017395:Plasminogen Activator Inhibitor 1; D000990:Antithrombin III; D005167:Factor VII; D005340:Fibrinogen