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Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components.
Lancet. 1995 Dec 16; 346(8990):1589-93.Lct

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.

Authors+Show Affiliations

Boston Collaborative Drug Surveillance Program, Boston University Medical Center, Lexington, MA 02173, USA.No 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

7500750

Citation

Jick, H, et al. "Risk of Idiopathic Cardiovascular Death and Nonfatal Venous Thromboembolism in Women Using Oral Contraceptives With Differing Progestagen Components." Lancet (London, England), vol. 346, no. 8990, 1995, pp. 1589-93.
Jick H, Jick SS, Gurewich V, et al. Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components. Lancet. 1995;346(8990):1589-93.
Jick, H., Jick, S. S., Gurewich, V., Myers, M. W., & Vasilakis, C. (1995). Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components. Lancet (London, England), 346(8990), 1589-93.
Jick H, et al. Risk of Idiopathic Cardiovascular Death and Nonfatal Venous Thromboembolism in Women Using Oral Contraceptives With Differing Progestagen Components. Lancet. 1995 Dec 16;346(8990):1589-93. PubMed PMID: 7500750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components. AU - Jick,H, AU - Jick,S S, AU - Gurewich,V, AU - Myers,M W, AU - Vasilakis,C, PY - 1995/12/16/pubmed PY - 1995/12/16/medline PY - 1995/12/16/entrez KW - Biology KW - Cardiovascular Effects KW - Case Control Studies KW - Cohort Analysis KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Methods KW - Demographic Factors KW - Desogestrel KW - Developed Countries KW - Diseases KW - Embolism KW - Europe KW - Excess Mortality--women KW - Family Planning KW - Gestodene KW - Incidence KW - Levonorgestrel KW - Measurement KW - Mortality KW - Northern Europe KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Physiology KW - Population KW - Population Dynamics KW - Research Methodology KW - Research Report KW - Retrospective Studies KW - Studies KW - Thromboembolism KW - United Kingdom KW - Vascular Diseases SP - 1589 EP - 93 JF - Lancet (London, England) JO - Lancet VL - 346 IS - 8990 N2 - 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. SN - 0140-6736 UR - https://www.unboundmedicine.com/medline/citation/7500750/Risk_of_idiopathic_cardiovascular_death_and_nonfatal_venous_thromboembolism_in_women_using_oral_contraceptives_with_differing_progestagen_components_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(95)91928-7 DB - PRIME DP - Unbound Medicine ER -