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The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women.
Contraception. 1997 Sep; 56(3):129-40.C

Abstract

The objective of this study was to assess the risk of myocardial infarction (MI) associated with the use of new and old combination oral contraceptives (OC). A matched case-control study in 16 centers in Germany, the United Kingdom, France, Austria, and Switzerland explored the association of current use of combination OC with the occurrence of MI. Our subjects were 182 women aged 16-44 years with MI; the controls were 635 women without MI (at least one hospital control and one community control per case) matched for 5-year age group and region. The main outcome measures were odds ratios comparing current use of a specific group of OC against current use of other groups or against no current use. The adjusted overall odds ratio (OR; 95% confidence intervals) for MI for second generation OC versus no current use was 2.35 (1.42 to 3.89) and 0.82 (0.29 to 2.31) for third generation OC (low dose ethinyl estradiol, gestodene, and desogestrel). A direct comparison of third generation users with second generation users yielded an OR of 0.28 (0.09 to 0.86). In subgroup analyses, the odds ratio for the UK alone was 1.25 (0.36 to 4.29), while for continental Europe it was 0.10 (0.02 to 0.48). For hospital controls, the risk estimated was 0.98 (0.22 to 4.44), and 0.18 (0.04 to 0.65) for community controls. The independent risk of MI among current smokers adjusted for OC use was 7.21 (4.58 to 11.36). Among users of third generation OC, the OR for current smokers was 3.75 (0.65 to 21.74) and among users of second generation it was 9.50 (2.93 to 30.96). A comparison of OC use in the UK for the time before and after regulatory action was taken in October 1995 shows that the likelihood of a control (last control accrued June 1996) being treated with second generation OC is seven times higher after 1 November 1995 than it was before. Third generation OC are the first to be associated with no excess risk of MI. A significantly lower risk of MI is found when comparing use of third generation OC with use of second generation OC. There seems to be an impressive amelioration of risk among smokers using newer OC. An impact of regulatory action in the UK was found in the OC use spectrum of controls.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9347202

Citation

Lewis, M A., et al. "The Use of Oral Contraceptives and the Occurrence of Acute Myocardial Infarction in Young Women. Results From the Transnational Study On Oral Contraceptives and the Health of Young Women." Contraception, vol. 56, no. 3, 1997, pp. 129-40.
Lewis MA, Heinemann LA, Spitzer WO, et al. The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Contraception. 1997;56(3):129-40.
Lewis, M. A., Heinemann, L. A., Spitzer, W. O., MacRae, K. D., & Bruppacher, R. (1997). The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Contraception, 56(3), 129-40.
Lewis MA, et al. The Use of Oral Contraceptives and the Occurrence of Acute Myocardial Infarction in Young Women. Results From the Transnational Study On Oral Contraceptives and the Health of Young Women. Contraception. 1997;56(3):129-40. PubMed PMID: 9347202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women. AU - Lewis,M A, AU - Heinemann,L A, AU - Spitzer,W O, AU - MacRae,K D, AU - Bruppacher,R, PY - 1997/11/5/pubmed PY - 1997/11/5/medline PY - 1997/11/5/entrez KW - Austria KW - Behavior KW - Case Control Studies KW - Contraception KW - Contraceptive Agents, Female--pharmacodynamics KW - Contraceptive Agents, Progestin--pharmacodynamics KW - Contraceptive Agents--pharmacodynamics KW - Contraceptive Methods--side effects KW - Desogestrel--pharmacodynamics KW - Developed Countries KW - Diseases KW - Europe KW - Evaluation KW - Family Planning KW - France KW - Germany KW - Gestodene--pharmacodynamics KW - Heart Diseases KW - Levonorgestrel--pharmacodynamics KW - Mediterranean Countries KW - Myocardial Infarction KW - Northern Europe KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Research Methodology KW - Research Report KW - Risk Assessment KW - Smoking KW - Studies KW - Switzerland KW - United Kingdom KW - Western Europe SP - 129 EP - 40 JF - Contraception JO - Contraception VL - 56 IS - 3 N2 - The objective of this study was to assess the risk of myocardial infarction (MI) associated with the use of new and old combination oral contraceptives (OC). A matched case-control study in 16 centers in Germany, the United Kingdom, France, Austria, and Switzerland explored the association of current use of combination OC with the occurrence of MI. Our subjects were 182 women aged 16-44 years with MI; the controls were 635 women without MI (at least one hospital control and one community control per case) matched for 5-year age group and region. The main outcome measures were odds ratios comparing current use of a specific group of OC against current use of other groups or against no current use. The adjusted overall odds ratio (OR; 95% confidence intervals) for MI for second generation OC versus no current use was 2.35 (1.42 to 3.89) and 0.82 (0.29 to 2.31) for third generation OC (low dose ethinyl estradiol, gestodene, and desogestrel). A direct comparison of third generation users with second generation users yielded an OR of 0.28 (0.09 to 0.86). In subgroup analyses, the odds ratio for the UK alone was 1.25 (0.36 to 4.29), while for continental Europe it was 0.10 (0.02 to 0.48). For hospital controls, the risk estimated was 0.98 (0.22 to 4.44), and 0.18 (0.04 to 0.65) for community controls. The independent risk of MI among current smokers adjusted for OC use was 7.21 (4.58 to 11.36). Among users of third generation OC, the OR for current smokers was 3.75 (0.65 to 21.74) and among users of second generation it was 9.50 (2.93 to 30.96). A comparison of OC use in the UK for the time before and after regulatory action was taken in October 1995 shows that the likelihood of a control (last control accrued June 1996) being treated with second generation OC is seven times higher after 1 November 1995 than it was before. Third generation OC are the first to be associated with no excess risk of MI. A significantly lower risk of MI is found when comparing use of third generation OC with use of second generation OC. There seems to be an impressive amelioration of risk among smokers using newer OC. An impact of regulatory action in the UK was found in the OC use spectrum of controls. SN - 0010-7824 UR - https://www.unboundmedicine.com/medline/citation/9347202/The_use_of_oral_contraceptives_and_the_occurrence_of_acute_myocardial_infarction_in_young_women__Results_from_the_Transnational_Study_on_Oral_Contraceptives_and_the_Health_of_Young_Women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010782497001182 DB - PRIME DP - Unbound Medicine ER -