Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

Lidegaard, Øjvind

doi:10.1136/bmj.306.6883.956

Cited by 196 publications

(109 citation statements)

References 38 publications

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“…We included only 6 case-control studies. 18,[21][22][23][24][25] Characteristics of the included studies are summarizing in the Table. Four of them were carried out in Europe, 21,22,24,25 one in the United States, 23 and one worldwide. 18 Stroke was documented and diagnosed with clinical and radiological tools.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies dealt with ischemic stroke, 22,24,25 whereas the others provided data on both ischemic and hemorrhagic strokes. 18,21,23 Participants' age in the included articles ranged from 15 to 44 years old, and controls were matched for age. The number of subjects varied across the studies (from 26 to 1828 for cases and from 224 to 5334 for controls).…”

Section: Resultsmentioning

confidence: 99%

“…The number of subjects varied across the studies (from 26 to 1828 for cases and from 224 to 5334 for controls). Subjects were exposed to oral POC in 4 studies, 21,22,24,25 or to oral and injectable POC in another one, 18 or to Norplant in the last one. 22 Types of POCs are detailed in the Table. Nonusers included never and former users.…”

Section: Resultsmentioning

confidence: 99%

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Progestogen-Only Contraceptives and the Risk of Stroke

Chakhtoura

Canonico

Gompel

et al. 2009

Stroke

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Background and Purpose-The association between combined oral contraceptives (OC) use and increased risk of stroke has been reported. While progestogen-only contraceptives (POC) are commonly used worldwide, their impact on cardiovascular disease remains unclear. Methods-A meta-analysis based on EMBASE and MEDLINE referenced literature corresponding to OCs marketed since 1960 was carried out. Eligible articles assessing the risk of stroke in relation to OC or POC were reviewed, and relevant studies were extracted. All types of POC and routes of administration were taken into account in the meta-analysis. Results-Six case-control studies were identified. The combined odd ratio (OR) showed no increase in the risk of stroke among POC users (ORϭ0.96; 95% confidence interval: 0.70 to 1.31). This result was similar according to the route of administration (either implant or injectable or oral POC). Conclusion-Data from observational studies show that POC use is not associated with an increased risk of stroke.However, these results are based on limited data. Further investigations are needed in women with risk factors of stroke.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Progestogen-Only Contraceptives and the Risk of Stroke

Chakhtoura

Canonico

Gompel

et al. 2009

Stroke

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“…The majority of studies of second-generation oral contraceptives containing lower doses of estrogens did not find an increased risk of stroke. [242][243][244][245][246] However, one study did report an increased risk of stroke in women using first-, second-, or third-generation oral contraceptives. 247 The reasons for this discrepancy are not certain.…”

Section: Oral Contraceptive Usementioning

confidence: 99%

Primary Prevention of Ischemic Stroke

Goldstein¹,

Adams²,

Becker³

et al. 2001

Circulation

405

196

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“…[8][9] As low-dose OCs became widely used, studies indicated a lower thrombotic risk. [21][22][23] It is now generally accepted that the use of low-dose OCs decreases the thrombotic risk compared with higher-dose compounds. This finding is particularly true for deep vein thrombosis 22,24 but may not be as well defined for arterial events such as stroke and myocardial infarction.…”

Section: Ocs and Thrombosismentioning

confidence: 99%

Oral Contraceptives and Hormone Replacement Therapy Do Not Increase the Incidence of Arterial Thrombosis in a Nonhuman Primate Model

Bellinger

Williams

Adams

et al. 1998

ATVB

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Abstract-Older oral contraceptive (OC) formulations containing high doses of potent synthetic estrogens and progestins are associated with increased risk of thrombosis. To examine the effects of current low-dose OC and hormone replacement therapy (HRT) regimens on arterial thrombosis, premenopausal and surgically postmenopausal cynomolgus monkeys were divided into four treatment groups. Premenopausal monkeys were given either no OCs or ethinyl estradiol and levonorgestrel as an OC at a dose equivalent to that currently given to women. Postmenopausal monkeys were given either no HRT or conjugated equine estrogens and medroxyprogesterone as an HRT at a dose equivalent to that currently given to women. The monkeys were fed an atherogenic diet containing these treatments for 27 to 30 months. At the end of this time, arterial thrombosis was evaluated with a standardized stenosis/injury procedure in the left carotid artery. Blood flow velocity was monitored for cyclic or permanent occlusive thrombosis. The current OC and HRT regimens did not increase the susceptibility of the artery wall to develop an occlusive thrombus following injury and stenosis. In fact, there was a reduction in the incidence of thrombosis in the OC animals compared with untreated controls. Increased amounts of atherosclerosis were associated with an increased incidence of occlusive arterial thrombosis. Several selected coagulation parameters [von Willebrand factor, protein C, lipoprotein(a), and platelet aggregation] did not appear to be associated with either the amount of atherosclerosis or incidence of arterial thrombosis.(Arterioscler Thromb Vasc Biol. 1998;18:92-99.)

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Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

Abstract: Objective-To assess the risk ofcerebral thromboembolism in women using low dose oral contraceptives.Design-A retrospective case-control study.Setting-All Danish medical, neurological, neurosurgical, and gynaecological departments.Subjects

Cited by 196 publications

References 38 publications

Progestogen-Only Contraceptives and the Risk of Stroke

Progestogen-Only Contraceptives and the Risk of Stroke

Primary Prevention of Ischemic Stroke

Oral Contraceptives and Hormone Replacement Therapy Do Not Increase the Incidence of Arterial Thrombosis in a Nonhuman Primate Model

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