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Oral contraceptives and myocardial infarction: results of the MICA case-control study.
BMJ. 1999 Jun 12; 318(7198):1579-83.BMJ

Abstract

OBJECTIVES

To determine the association between myocardial infarction and use of different types of oral contraception in young women.

DESIGN

Community based case-control study. Data from interviews and general practice records.

SETTING

England, Scotland, and Wales.

PARTICIPANTS

Cases (n=448) were recruited from women aged between 16 and 44 who had suffered an incident myocardial infarction between 1 October 1993 and 16 October 1995. Controls (n=1728) were women without a diagnosis of myocardial infarction matched for age and general practice.

MAIN OUTCOME MEASURES

Odds ratios for myocardial infarction in current users of all combined oral contraceptives stratified by their progestagen content compared with non-users; current users of third generation versus second generation oral contraceptives.

RESULTS

The adjusted odds ratio for myocardial infarction was 1.40 (95% confidence interval 0.78 to 2. 52) for all combined oral contraceptive users, 1.10 (0.52 to 2.30) for second generation users, and 1.96 (0.87 to 4.39) for third generation users. Subgroup analysis by progestagen content did not show any significant difference from 1, and there was no effect of duration of use. The adjusted odds ratio for third generation users versus second generation users was 1.78 (0.66 to 4.83). 87% of cases were not exposed to an oral contraceptive, and 88% had clinical cardiovascular risk factors or were smokers, or both. Smoking was strongly associated with myocardial infarction: adjusted odds ratio 12.5 (7.29 to 21.5) for smoking 20 or more cigarettes a day.

CONCLUSIONS

There was no significant association between the use of oral contraceptives and myocardial infarction. The modest and non-significant point estimates for this association have wide confidence intervals. There was no significant difference between second and third generation products.

Authors+Show Affiliations

Drug Safety Research Unit, Bursledon Hall, Southampton SO31 1AA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10364115

Citation

Dunn, N, et al. "Oral Contraceptives and Myocardial Infarction: Results of the MICA Case-control Study." BMJ (Clinical Research Ed.), vol. 318, no. 7198, 1999, pp. 1579-83.
Dunn N, Thorogood M, Faragher B, et al. Oral contraceptives and myocardial infarction: results of the MICA case-control study. BMJ. 1999;318(7198):1579-83.
Dunn, N., Thorogood, M., Faragher, B., de Caestecker, L., MacDonald, T. M., McCollum, C., Thomas, S., & Mann, R. (1999). Oral contraceptives and myocardial infarction: results of the MICA case-control study. BMJ (Clinical Research Ed.), 318(7198), 1579-83.
Dunn N, et al. Oral Contraceptives and Myocardial Infarction: Results of the MICA Case-control Study. BMJ. 1999 Jun 12;318(7198):1579-83. PubMed PMID: 10364115.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral contraceptives and myocardial infarction: results of the MICA case-control study. AU - Dunn,N, AU - Thorogood,M, AU - Faragher,B, AU - de Caestecker,L, AU - MacDonald,T M, AU - McCollum,C, AU - Thomas,S, AU - Mann,R, PY - 1999/6/11/pubmed PY - 1999/6/11/medline PY - 1999/6/11/entrez KW - Behavior KW - Biology KW - Case Control Studies KW - Contraception KW - Contraceptive Methods--side effects KW - Developed Countries KW - Diseases KW - England KW - Europe KW - Family Planning KW - Heart Diseases KW - Myocardial Infarction--women KW - Northern Europe KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Research Methodology KW - Research Report KW - Risk Factors--women KW - Scotland KW - Smoking--women KW - Studies KW - United Kingdom KW - Wales KW - Women SP - 1579 EP - 83 JF - BMJ (Clinical research ed.) JO - BMJ VL - 318 IS - 7198 N2 - OBJECTIVES: To determine the association between myocardial infarction and use of different types of oral contraception in young women. DESIGN: Community based case-control study. Data from interviews and general practice records. SETTING: England, Scotland, and Wales. PARTICIPANTS: Cases (n=448) were recruited from women aged between 16 and 44 who had suffered an incident myocardial infarction between 1 October 1993 and 16 October 1995. Controls (n=1728) were women without a diagnosis of myocardial infarction matched for age and general practice. MAIN OUTCOME MEASURES: Odds ratios for myocardial infarction in current users of all combined oral contraceptives stratified by their progestagen content compared with non-users; current users of third generation versus second generation oral contraceptives. RESULTS: The adjusted odds ratio for myocardial infarction was 1.40 (95% confidence interval 0.78 to 2. 52) for all combined oral contraceptive users, 1.10 (0.52 to 2.30) for second generation users, and 1.96 (0.87 to 4.39) for third generation users. Subgroup analysis by progestagen content did not show any significant difference from 1, and there was no effect of duration of use. The adjusted odds ratio for third generation users versus second generation users was 1.78 (0.66 to 4.83). 87% of cases were not exposed to an oral contraceptive, and 88% had clinical cardiovascular risk factors or were smokers, or both. Smoking was strongly associated with myocardial infarction: adjusted odds ratio 12.5 (7.29 to 21.5) for smoking 20 or more cigarettes a day. CONCLUSIONS: There was no significant association between the use of oral contraceptives and myocardial infarction. The modest and non-significant point estimates for this association have wide confidence intervals. There was no significant difference between second and third generation products. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/10364115/Oral_contraceptives_and_myocardial_infarction:_results_of_the_MICA_case_control_study_ L2 - https://www.bmj.com/lookup/pmidlookup?view=long&pmid=10364115 DB - PRIME DP - Unbound Medicine ER -