Title
Cardiovascular risk markers during treatment with estradiol and trimegestone or dydrogesterone
Author
Hellgren, M.
Conard, J.
Norris, L.
Kluft, C.
TNO Kwaliteit van Leven
Publication year
2009
Abstract
Objective: To study cardiovascular risk markers in women taking estradiol/trimegestone or estradiol/dydrogesterone. Design: Multicenter, randomized, prospective, double-blind study of 184 healthy post-menopausal women randomized to 6 cycles of either estradiol (2 mg) + trimegestone (0.5 mg) (T-group) or estradiol (2 mg) + dydrogesterone (10 mg) (DYDR group). Cardiovascular risk markers were measured before, after cycle 1, 3 and 6 and at 4 weeks post-treatment. Results: Fibrinogen was reduced in both groups but more markedly in the DYDR group. Factor VIIc activity levels decreased in both groups with a greater change in the T-group. Factor VII antigen was increased in both groups with a greater increase in the DYDR group. Factor VIIa was increased in the DYDR group only. Plasminogen levels were also increased in both groups with a greater increase in the T-group. There were no statistically significant changes in lipid variables between the different regimens. Changes in total cholesterol and LDL cholesterol were correlated positively with changes in factor VIIc in the DYDR group and negatively with changes in factor VIIc in the T-group. Trigemestone was associated with a better bleeding pattern. Conclusions: Trimegestone was associated with less procoagulant changes in factor VIIa and factor VIIc activity and larger decrease in PAI-1 activity compared with the dydrogesterone preparation. These results reflect less androgenic properties of the trimegestone preparation. The fibrinogen level and Lp(a) were more decreased during dydrogesterone treatment. Further investigation is required to clarify the relative importance of beneficial effects with respect to cardiovascular risk. © 2009.
Subject
Biology
Biomedical Research
Blood coagulation
Cardiovascular risk
Endometrial protection
Fibrinolysis
Hormone therapy
Lipids
Menopause
dydrogesterone
estradiol
gestagen
low density lipoprotein cholesterol
trimegestone
adult
article
cardiovascular risk
cholesterol blood level
clinical trial
controlled clinical trial
controlled study
double blind procedure
drug effect
female
fibrinolysis
human
major clinical study
postmenopause
randomized controlled trial
Adult
Aged
Biological Markers
Blood Coagulation Factors
Cardiovascular Diseases
Double-Blind Method
Drug Therapy, Combination
Dydrogesterone
Estradiol
Estrogen Replacement Therapy
Estrogens
Female
Fibrinolysis
Humans
Lipids
Middle Aged
Postmenopause
Progestins
Promegestone
Risk Factors
Thromboembolism
Uterine Hemorrhage
To reference this document use:
http://resolver.tudelft.nl/uuid:c4b342c6-9c4c-4ad4-80fb-40babc72f1f1
DOI
https://doi.org/10.1016/j.maturitas.2009.01.004
TNO identifier
241444
ISSN
0378-5122
Source
Maturitas, 62 (3), 287-293
Document type
article