Oral Contraceptives and the Risk of Myocardial Infarction

Some studies have indicated that women who take oral contraceptives have an increased risk of myocardial infarction. This study focused specifically on second- and third-generation oral contraceptives. The risk of myocardial infarction was significantly increased by the use of second-generation pills; the findings regarding the use of third-generation pills were inconclusive but suggested that the risk was lower than that with second-generation pills. The risk was increased with second-generation pills. It may be lower with third-generation pills. The first report of coronary thrombosis associated with the use of oral contraceptives appeared in 1963. 1 Later studies established the use of oral contraceptives as a risk factor for venous as well as arterial thrombosis. 2 – 7 Various modifications were made in an attempt to lower these risks, including a reduction in the estrogen dose and changes in the progestagen compound. Oral contraceptives containing an estrogen and the progestagen desogestrel or gestodene, available since the 1980s, are associated with at least a doubling of the risk of venous thrombosis as compared with other combined oral contraceptives. 8 – 12 It has been suggested . . .