Comparison of progression of coronary calcium in postmenopausal women on versus not on estrogen/progestin therapy.
The prophylactic effect of postmenopausal hormone replacement therapy on coronary atherosclerosis remains controversial. We, therefore, examined the influence of combined estrogen/progestin therapy on the progression of coronary calcium as a marker of coronary atherosclerosis. We determined the extent of coronary calcium in 277 women (age 57 +/- 6 years, time after menopause 3.9 +/- 2.4 years, group I) at the beginning of hormone replacement therapy using multislice computed tomography. For quantification, we calculated the volume score. After an observation period of 3 years, we determined the progression of coronary calcium in a second scan. The results were compared with those from an age- and risk factor-adjusted group of postmenopausal women without hormone substitution (group II). No significant difference was found in the volume score (59 +/- 95 vs 58 +/- 88) or risk factor distribution between the 2 groups on study entry. In 56 women of group I and 52 women of group II, coronary calcium could be excluded on the initial scan (p = NS). After a mean observation time of 38.5 +/- 4.9 months, we observed no significant difference between the 2 groups regarding an increase in volume score (17 +/- 24 vs 19 +/- 27, p = NS) or the fraction of women with an increase in volume score (82.2% vs 84.2%). In conclusion, a reduced progression of coronary calcium in postmenopausal women on combined estrogen/progestin therapy could not be observed compared with a matched group of women without hormone substitution.
Becker
Alexander
A
Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany. alexander.becker@med.uni-muenchen.de
Leber
Alexander
A
von Ziegler
Franz
F
Becker
Christoph
C
Knez
Andreas
A
D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D002118:Calcium / Q000378:metabolism; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000009:adverse effects / Q000627:therapeutic use; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
D003271:Contraceptive Agents, Female; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D017258:Medroxyprogesterone Acetate; D002118:Calcium