title: Interaction between oral estrogen plus progestogen therapy and ABO blood groups on coagulation activation in postmenopausal women.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of postmenopausal hormone therapy on coagulation and whether this effect differs according to ABO blood groups.
  
  
  METHODS
  This was a prospective observational study to evaluate factor VIII (FVIII) activity, factor von Willebrand (vWF), and D-dimer (D-Di) levels and ABO blood groups in 61 postmenopausal women using oral estrogen plus progestogen therapy (EPT; 2 mg estradiol + 1 mg norethisterone acetate) for 3 months and in 101 women not using EPT. After 3 months, all eligible women who had completed the treatment scheme proposed for the EPT group or those who opted to participate but had not undergone EPT had a blood sample collected for analysis.
  
  
  RESULTS
  Significant differences were observed in FVIII activity and vWF levels in the control group between those carrying group O and non-group O blood. For EPT users, significant differences were observed for FVIII activity, vWF, and D-Di levels. After a multivariate regression analysis, FVIII activity and ABO blood groups were independently associated with vWF levels, whereas interaction between ABO blood groups and EPT were independently associated with FVIII activity. Besides diabetes, the ABO × EPT interaction was also noted to be independently associated with D-Di levels.
  
  
  CONCLUSIONS
  These findings suggest an interactive effect between oral EPT and non-O blood groups, contributing to the mechanism by which estrogen triggers the hypercoagulability state and increased risk for venous thrombosis in women undergoing oral EPT.
authors.affiliation: Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Daniela Amorim Melgaço
authors.initials: DA
authors.lastname: Guimarães
authors.forename: Mariana Silva
authors.initials: MS
authors.lastname: dos Santos
authors.forename: Karina Braga
authors.initials: KB
authors.lastname: Gomes
authors.forename: Johanna G
authors.initials: JG
authors.lastname: van der Bom
authors.forename: Danyelle Romana
authors.initials: DR
authors.lastname: Rios
authors.forename: Jarbas
authors.initials: J
authors.lastname: Cardoso
authors.forename: Romerson Martins
authors.initials: RM
authors.lastname: Franco
authors.forename: George da Silva
authors.initials: Gda S
authors.lastname: Teixeira
authors.forename: Luci Maria Sant'Ana
authors.initials: LM
authors.lastname: Dusse
authors.forename: Maria das Graças
authors.initials: Md
authors.lastname: Carvalho
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Fernandes
mesh_terms: D000017:ABO Blood-Group System / Q000502:physiology*; D001777:Blood Coagulation / Q000187:drug effects*; D004967:Estrogens / Q000009:adverse effects* / Q000627:therapeutic use; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011372:Progestins / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D019851:Thrombophilia / Q000139:chemically induced*; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D000017:ABO Blood-Group System; D004967:Estrogens; D005338:Fibrin Fibrinogen Degradation Products; D011372:Progestins; C036309:fibrin fragment D; D014841:von Willebrand Factor; D005169:Factor VIII