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Hormonal replacement therapy, prothrombotic mutations and the risk of venous thrombosis
Author(s) -
Rosendaal F. R.,
Vessey M.,
Rumley A.,
Daly E.,
Woodward M.,
Helmerhorst F. M.,
Lowe G. D. O.
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.0007-1048.2002.03356.x
Subject(s) - medicine , odds ratio , factor v leiden , thrombosis , venous thrombosis , risk factor , hormone replacement therapy (female to male) , case control study , thrombophilia , confidence interval , gastroenterology , cardiology , surgery , testosterone (patch)
Summary. Hormone replacement therapy (HRT) increases the risk of venous thrombosis. We investigated whether this risk is affected by carriership of hereditary prothrombotic abnormalities. Therefore, we determined the two most common prothrombotic mutations, factor V Leiden and prothrombin 20210A in women who participated in a case–control study on venous thrombosis. Relative risks were expressed as odds ratios (OR) with 95% confidence intervals (CI95). Among 77 women aged 45–64 years with a first venous thrombosis, 51% were receiving HRT at the time of thrombosis, compared with 24% of control women (OR = 3·3, CI95 1·8–5·8). Among the patients, 23% had a prothrombotic defect, versus 7% among the control women (OR = 3·8, CI95 1·7–8·5). Women who had factor V Leiden and used HRT had a 15‐fold increased risk (OR = 15·5, CI95 3·1–77), which exceeded the expected joint odds ratio of 6·1 (under an additive model). We conclude that the thrombotic risk of HRT may particularly affect women with prothrombotic mutations. Efforts to avoid HRT in women with increased risk of thrombosis are advisable.