Hormone therapy, C-reactive protein, and progression of atherosclerosis: data from the Estrogen Replacement on Progression of Coronary Artery Atherosclerosis (ERA) trial.
OBJECTIVE
To compare the effects of estrogen and estrogen plus progestin on levels of C-reactive protein (CRP) and interleukin-6 (IL-6), and to examine the relationship between these changes and progression of angiographically defined coronary disease.


METHODS
Baseline and follow-up (year 1 and year 3) plasma levels of IL-6 and CRP were measured in a subset of 232 patients from the Estrogen Replacement in Atherosclerosis (ERA) trial.


RESULTS
Serial angiograms were also available at baseline and closeout. Estrogen alone increased CRP by 40% (P = .01) at 1 year and 38% P = .002) at closeout. Estrogen plus medroxyprogesterone acetate increased CRP by 44.7% P = .001) at 1 year and 54.7% P = .0001) at closeout as compared with baseline levels. There were no significant changes in IL-6 with either treatment. In women in the active treatment arm, change in CRP during the first year was not associated with progression of coronary disease P = .2).


CONCLUSIONS
Estrogen and estrogen plus medroxyprogesterone significantly raise CRP levels in women with established coronary disease. In contrast, IL-6 levels are not affected by estrogen or estrogen plus progestin. Estrogen-induced changes in CRP are not associated with progression of atherosclerosis.
Lakoski
Susan G
SG
Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Brosnihan
Bridget
B
Herrington
David M
DM
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D003324:Coronary Artery Disease / Q000097:blood*; D018450:Disease Progression; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D011372:Progestins / Q000627:therapeutic use*
D015850:Interleukin-6; D011372:Progestins; D002097:C-Reactive Protein