Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components

Concern about the risks of cardiovascular illness in women using combined oral contraceptives (OC) containing the progestagens desogestrel and gestodene prompted two studies of data from the UK General Practice Research Database. We compared the risks of certain cardiovascular illnesses in otherwise...

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Veröffentlicht in:The Lancet (British edition) 1995-12, Vol.346 (8990), p.1589-1593
Hauptverfasser: JICK, H, JICK, S. S, GUREWICH, V, MYERS, M. W, VASILAKIS, C
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container_issue 8990
container_start_page 1589
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creator JICK, H
JICK, S. S
GUREWICH, V
MYERS, M. W
VASILAKIS, C
description Concern about the risks of cardiovascular illness in women using combined oral contraceptives (OC) containing the progestagens desogestrel and gestodene prompted two studies of data from the UK General Practice Research Database. We compared the risks of certain cardiovascular illnesses in otherwise healthy women exposed to one of three OCs containing < 35 micrograms oestrogen plus levonorgestrel, desogestrel, or gestodene. In the first study, based on some 470 general practices, there were 15 cases of unexpected idiopathic cardiovascular death among 303,470 women who were current users of one of the study OCs. The estimated incidence rates were 8/184,536 (4.3 per 100,000) woman-years at risk for users of combined OCs containing levonorgestrel, 2/135,567 (1.5 per 100,000) for desogestrel users, and 5/105,201 (4.8 per 100,000) for gestodene users. The relative risk (RR) estimates were 0.4 (95% CI 0.1-2.1) and 1.4 (CI 0.5-4.5) for desogestrel and gestodene, respectively, compared with levonorgestrel. In the second study, derived from some 370 general practices, there were 80 cases of nonfatal venous thromboembolism (VTE) in a cohort of 238,130 otherwise healthy women. The incidence rates of VTE per 100,000 woman-years at risk were 16.1 for levonorgestrel users, 29.3 for desogestrel, and 28.1 for gestodene. The adjusted RR estimates from the cohort analysis were 1.9 (1.1-3.2) and 1.8 (1.0-3.2) for desogestrel and gestodene users, respectively, compared with users of levonorgestrel. In a nested case-control analysis the adjusted matched RR estimates were 2.2 (1.1-4.4) and 2.1 (1.0-4.4) for desogestrel and gestodene users, respectively, compared with users of levonorgestrel. The excess risk for nonfatal VTE associated with the new generation of combined OCs containing low-dose oestrogen and the progestagens desogestrel or gestodene compared with levonorgestrel is estimated to be 16 per 100,000 woman-years.
doi_str_mv 10.1016/S0140-6736(95)91928-7
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In a nested case-control analysis the adjusted matched RR estimates were 2.2 (1.1-4.4) and 2.1 (1.0-4.4) for desogestrel and gestodene users, respectively, compared with users of levonorgestrel. 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The incidence rates of VTE per 100,000 woman-years at risk were 16.1 for levonorgestrel users, 29.3 for desogestrel, and 28.1 for gestodene. The adjusted RR estimates from the cohort analysis were 1.9 (1.1-3.2) and 1.8 (1.0-3.2) for desogestrel and gestodene users, respectively, compared with users of levonorgestrel. In a nested case-control analysis the adjusted matched RR estimates were 2.2 (1.1-4.4) and 2.1 (1.0-4.4) for desogestrel and gestodene users, respectively, compared with users of levonorgestrel. The excess risk for nonfatal VTE associated with the new generation of combined OCs containing low-dose oestrogen and the progestagens desogestrel or gestodene compared with levonorgestrel is estimated to be 16 per 100,000 woman-years.</abstract><cop>London</cop><pub>Lancet</pub><pmid>7500750</pmid><doi>10.1016/S0140-6736(95)91928-7</doi><tpages>5</tpages></addata></record>
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identifier ISSN: 0140-6736
ispartof The Lancet (British edition), 1995-12, Vol.346 (8990), p.1589-1593
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subjects Adult
Biological and medical sciences
Birth control
Cardiovascular disease
Cardiovascular Diseases - chemically induced
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Case-Control Studies
Cohort Studies
Contraceptives
Contraceptives, Oral, Combined - adverse effects
Desogestrel - adverse effects
Drug toxicity and drugs side effects treatment
Estrogens
Ethinyl Estradiol - administration & dosage
Female
Health risks
Humans
Incidence
Levonorgestrel - adverse effects
Medical research
Medical sciences
Norpregnenes - adverse effects
Pharmacology. Drug treatments
Progestins - adverse effects
Risk Factors
Thromboembolism
Thromboembolism - chemically induced
Thromboembolism - epidemiology
Toxicity: cardiovascular system
Women
title Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components
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