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 |
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| 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 |
| format | Article |
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S ; GUREWICH, V ; MYERS, M. W ; VASILAKIS, C</creator><creatorcontrib>JICK, H ; JICK, S. S ; GUREWICH, V ; MYERS, M. W ; VASILAKIS, C</creatorcontrib><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.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(95)91928-7</identifier><identifier>PMID: 7500750</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Lancet</publisher><subject>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</subject><ispartof>The Lancet (British edition), 1995-12, Vol.346 (8990), p.1589-1593</ispartof><rights>1996 INIST-CNRS</rights><rights>Copyright Lancet Ltd. 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W</creatorcontrib><creatorcontrib>VASILAKIS, C</creatorcontrib><title>Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><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.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - chemically induced</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Contraceptives</subject><subject>Contraceptives, Oral, Combined - adverse effects</subject><subject>Desogestrel - adverse effects</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Estrogens</subject><subject>Ethinyl Estradiol - administration & dosage</subject><subject>Female</subject><subject>Health risks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Levonorgestrel - adverse effects</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Norpregnenes - adverse effects</subject><subject>Pharmacology. 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S</au><au>GUREWICH, V</au><au>MYERS, M. W</au><au>VASILAKIS, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1995-12-16</date><risdate>1995</risdate><volume>346</volume><issue>8990</issue><spage>1589</spage><epage>1593</epage><pages>1589-1593</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>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.</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 |
| issn | 0140-6736 1474-547X |
| language | eng |
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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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