Past oral contraceptive use and angiographic coronary artery disease in postmenopausal women: data from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation.
OBJECTIVE
To evaluate past oral contraceptive use and angiographic coronary artery disease in women.


METHODS
Academic medical centers.


METHODS
Six hundred seventy-two postmenopausal women enrolled in the Women's Ischemia Syndrome Evaluation (WISE) with coronary risk factors undergoing coronary angiography for suspected myocardial ischemia.


METHODS
Past oral contraceptive use, assessed by reproductive questionnaire.


METHODS
Quantitative coronary artery disease, assessed by a core angiography laboratory.


RESULTS
Past oral contraceptive use was associated with a lower mean coronary artery disease severity index score (mean +/- SD: 11.8 +/- 10.3 vs. 18.7 +/- 17.3) compared with non-prior users, despite age adjustment. Past oral contraceptive use remained a significant independent negative predictor of coronary artery disease severity when adjusting for coronary risk factors, including age, diabetes mellitus, triglycerides, low-density lipoprotein cholesterol, smoking, aspirin use, and lipid-lowering medication (model R2 = 0.19). The modeling indicated that past oral contraceptive use was associated with a 2.44 lower coronary artery disease severity score index. There was no apparent relationship between duration of past oral contraceptive use and the coronary artery disease severity index score.


CONCLUSIONS
Past oral contraceptive use is associated with less coronary artery disease, measured by quantitative coronary angiography, among postmenopausal women with suspected myocardial ischemia. These findings suggest that a prospective study should address the hypothesis that past oral contraceptive use during the premenopausal years might offer women protection from atherosclerotic coronary disease later in life.
Merz
C Noel Bairey
CN
Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute and Medical Center, Los Angeles, California, USA. merz@cshs.org
Johnson
B Delia
BD
Berga
Sarah
S
Braunstein
Glenn
G
Reis
Steven E
SE
Bittner
Vera
V
D000047:Academies and Institutes; D000368:Aged; D000792:Angiography / Q000706:statistics & numerical data; D003276:Contraceptives, Oral; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004363:Drug Utilization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D016387:Women's Health
D003276:Contraceptives, Oral