title: Risk of venous thromboembolic disease in postmenopausal women taking oral or transdermal hormone replacement therapy.
abstract: OBJECTIVE
  The influence of hormone replacement therapy (HRT) on hemostasis processes depends on the type of hormone, the combination of doses, the time of taking HRT, and the route of administration (oral, transdermal, implanted). The aim of the current study was to assess some parameters of coagulation, especially tissue factor pathway inhibitor (TFPI) and tissue factor (TF) in postmenopausal women using oral or transdermal HRT.
  
  
  METHODS
  The study was conducted on 76 healthy women, including 46 women aged 44-58 years who were taking oral (26) or transdermal (20) HRT, and 30 women aged 44-54 years who did not take HRT as the control group. Plasma concentrations of TF, TFPI, thrombin-antithrombin complex (TAT), and D-dimer were performed by enzyme-linked immunosorbent assay (ELISA). Moreover, the concentration of fibrinogen and activity of protein C were measured by chromogenic and chronometric methods.
  
  
  RESULTS
  We observed a significantly higher concentration of TF and a significantly lower concentration of TFPI in women taking oral and transdermal HRT in comparison with the control group. We also found a significantly lower concentration of fibrinogen in women taking oral HRT vs. the control group. Moreover, no statistically significant changes in concentrations of TAT and D-dimer, or activity of protein C were noted.
  
  
  CONCLUSIONS
  In this study, the occurrence of an increased TF concentration simultaneously with a decreased concentration of TFPI in women taking HRT indicates hypercoagulability. No significant modification of TAT or D-dimer occurred, and thus there may not be increased risk of thrombosis.
authors.affiliation: Department of Pathophysiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, st. Marii Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland. ruszkowska.basia@gmail.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Ruszkowska
authors.forename: Grażyna
authors.initials: G
authors.lastname: Gadomska
authors.forename: Liliana
authors.initials: L
authors.lastname: Bielis
authors.forename: Marzena
authors.initials: M
authors.lastname: Gruszka
authors.forename: Barbara
authors.initials: B
authors.lastname: Góralczyk
authors.forename: Danuta
authors.initials: D
authors.lastname: Rość
authors.forename: Grażyna
authors.initials: G
authors.lastname: Odrowąż-Sypniewska
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000990:Antithrombin III; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D012307:Risk Factors; D013925:Thromboplastin / Q000378:metabolism; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D008055:Lipids; D008074:Lipoproteins; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C051928:lipoprotein-associated coagulation inhibitor; D000990:Antithrombin III; D005340:Fibrinogen; D013925:Thromboplastin; D010447:Peptide Hydrolases