Print Email Facebook Twitter Inhibitors and activation markers of the haemostatic system during hormone therapy: A comparative study of oral estradiol (2 mg)/ dydrogesterone and estradiol (2 mg)/ trimegestone Title Inhibitors and activation markers of the haemostatic system during hormone therapy: A comparative study of oral estradiol (2 mg)/ dydrogesterone and estradiol (2 mg)/ trimegestone Author Norris, L.A. Brosnan, J. Bonnar, J. Conard, J. Kluft, C. Hellgren, M. TNO Kwaliteit van Leven Publication year 2008 Abstract Epidemiological studies have shown that hormone therapy (HT) increases the risk of venous thromboembolism in post menopausal women. The mechanism of this increased risk is unknown; however, activation of the haemostatic system is known to contribute to the pathogenesis of venous thromboembolism. In post-menopausal women the estrogen /progestogen composition of the HT can influence the level of haemostatic activation. It was the objective of this study to compare changes in inhibitors and activation markers of the haemostatic system in healthy post-menopausal women taking estradiol (2 mg) combined with dydrogesterone or a new progestin, trimegestone. A multicentre study of 186 women randomised to six months therapy with either estradiol (2 mg) +trimegestone (0.5 mg) or estradiol (2 mg) +dydrogesterone (10 mg) was performed. Antithrombin and protein S activity was decreased and activated protein C (APC) resistance, D-dimer and prothrombin fragment 1.2, were increased in both groups on treatment. Protein C activity was decreased and plasmin-antiplasmin complex was increased in the trimegestone group only. The increase in plasmin-antiplasmin complex and D-dimer was greater after six cycles of treatment in the trimegestone group compared with the dydrogesterone group. In conclusion, decreased levels of inhibitors of blood coagulation and increased thrombin production were found in both groups however a greater increase in the levels of plasmin-antiplasmin complex and D-dimer was found in the trimegestone group. This suggests an enhanced fibrinolytic response in this group. Further studies are required to determine the significance of this finding with respect to venous thrombosis risk. © 2008 Schattauer GmbH. Subject HealthHaemostasisHormonesVenous thrombosisActivated protein CAntiplasminAntithrombinBlood clotting factor 5 LeidenDydrogesterone plus estradiolEstradiol plus trimegestoneEstrogen derivativePlasminProtein SProthrombinAdultAgedClinical trialControlled clinical trialControlled studyDouble blind procedureDrug effectDrug inhibitionFemaleFibrinolysisGene mutationHormonal therapyHumanMedical assessmentMulticenter studyMultiple cycle treatmentPostmenopauseProtein blood levelProtein functionRandomized controlled trialAdministration, OralEstrogen Replacement TherapyFactor VHemostasisHumansMiddle AgedProgestinsPromegestoneProtein CProtein SRisk FactorsVenous Thrombosis To reference this document use: http://resolver.tudelft.nl/uuid:be9308b1-ad9a-4748-af12-18d89fdb1ba4 DOI https://doi.org/10.1160/th07-12-0746 TNO identifier 240938 ISSN 0340-6245 Source Thrombosis and Haemostasis, 100 (2), 253-260 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.