Patch Instead of Pill

Cushman, Mary

doi:10.1161/atvbaha.109.199083

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Transdermal estradiol does not appear to share the pro-thrombotic potential of oral estrogens with respect to venous thrombosis or stroke, but randomized trial evidence is lacking. 23,24 …”

Section: Discussionmentioning

confidence: 99%

Tissue Factor Pathway Inhibitor, Activated Protein C Resistance, and Risk of Ischemic Stroke due to Postmenopausal Hormone Therapy

Rossouw

Johnson

Pettinger

et al. 2012

Stroke

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Background and Purpose To test whether changes in plasma tissue factor pathway inhibitor (TFPI) levels or activated protein C resistance (normalized APC resistance ratio, nAPCsr) modify the increased risk of ischemic stroke due to postmenopausal hormone therapy (PHT). Methods Nested case-control study of 455 cases of ischemic stroke and 565 matched controls in the Women’s Health Initiative trials of PHT. Results Baseline free TFPI was associated with ischemic stroke risk, OR (95% CI) per SD increase = 1.17 (1.01, 1.37, p=0.039, but baseline nAPCsr was not, OR per SD increase = 0.89 (0.75, 1.05), p=0.15. Baseline TFPI levels and nAPCsr did not modify the effect of PHT on ischemic stroke. Treatment-induced mean changes of -28% in free TFPI and +65% in nAPCsr did not change the risk of ischemic stroke (interaction p = 0.452 and 0.971 respectively). In subgroup analyses baseline nAPCsr was inversely associated with lacunar strokes, OR per SD increase = 0.74 (0.57, 0.96), p=0.025, and baseline free TFPI interacted with treatment to increase large vessel atherosclerotic strokes, p=0.008. Conclusions Pro-coagulant changes in TFPI or nAPCsr do not modify the increased ischemic stroke risk due to PHT.

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“…Transdermal estradiol does not appear to share the pro-thrombotic potential of oral estrogens with respect to venous thrombosis or stroke, but randomized trial evidence is lacking. 23,24 …”

Section: Discussionmentioning

confidence: 99%