title: [Determination concentrations of tissue factor pathway inhibitor and their changes during estrogen replacement therapy].
abstract: OBJECTIVE
  The purpose of the present study was to determine changes of tissue factor pathway inhibitor (TFPI) as a biochemical risk factors of thromboembolism during the use of different administration methods of the early estrogen replacement therapy.
  
  
  METHODS
  Prospective randomized cross-over trial.
  
  
  METHODS
  General Faculty Hospital Prague.
  
  
  METHODS
  In a 12-week prospective, randomized, interventional, cross-over trial, estradiol was administered orally in a dose of 2 mg daily or transdermally in a dose of 0,05 mg daily. Forty-five healthy postmenopausal women were included into the study within 12 weeks after the hysterectomy and ovariectomy (surgical castration). Forty-one women completed the study and their data were analyzed. The average age was of 49 +/- 6 years. An enzymatic method (IMUBIND Total TFPI ELISA test) was employed for the determination of TFPI.
  
  
  RESULTS
  After the oral therapy, the average value of TFPI decreased statistically significantly (p < 0.0001) from 87.5 +/- 39.1 ng/ml to 68 +/- 37.49 ng/ml.
  
  
  CONCLUSIONS
  Statistically the oral therapy reduced significantly TFPI compared with the transdermal method of administration. In spite of the fact that these changes cannot be unambiguously considered as risky and that the zero change of D-dimers suggests that there was no activation of the coagulation cascade, we consider the neutral effect of the transdermal therapy as more beneficial. The lack of manifestations of the coagulation cascade activation demonstrates the safety of both administration forms of the estrogen replacement therapy in the case of the early administration.
authors.affiliation: Gynekologicko-porodnická klinika VFN Praha a 1, LF UK, Praha. tfait@seznam.cz
authors.forename: T
authors.initials: T
authors.lastname: Fait
authors.forename: B
authors.initials: B
authors.lastname: Trnková
authors.forename: M
authors.initials: M
authors.lastname: Kostírova
authors.forename: M
authors.initials: M
authors.lastname: Vrablík
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants; D000990:Antithrombin III / Q000032:analysis*; D002979:Climacteric; D018592:Cross-Over Studies; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008074:Lipoproteins / Q000097:blood*; D008875:Middle Aged; D010052:Ovariectomy
chemical_list: D000925:Anticoagulants; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D004958:Estradiol; D000990:Antithrombin III