Long-term hormone replacement therapy does not cause increased platelet activation.

Abstract:

BACKGROUND:Observational studies have shown apparently lower ischemic coronary disease risk in postmenopausal women receiving hormone replacement therapy (HRT). However, several recent studies have shown an increase in ischemic cardiac events when HRT is initiated in postmenopausal women with known coronary artery disease. It is postulated that estrogen may result in increased platelet aggregation. METHODS:We evaluated platelet activation, as measured by flow cytometric analysis using P selectin and PAC1 as activation markers, and aggregation, as measured by standard platelet aggregation using platelet-rich plasma, in 27 postmenopausal women (17 HRT, 10 placebo) who were participants in 2 placebo-controlled randomized angiographic trials evaluating the effect of HRT on coronary atherosclerosis or saphenous vein graft disease. All women had received HRT or placebo for >2 years and were on aspirin therapy. The estrogen component was either conjugated equine estrogen or 17beta-estradiol. RESULTS:Patients on HRT and those on placebo had comparable degrees of platelet aggregation when measured using various doses of agonists (adenosine diphosphate and epinephrine). There were no significant differences in levels of platelet activation measured by flow cytometry. CONCLUSION:We conclude that long-term HRT does not appear to cause increased platelet activation and aggregation in women with coronary artery disease. There may be increased platelet activation in the early period after HRT initiation; however, this was not assessed in this study.

journal_name

Am Heart J

journal_title

American heart journal

authors

Williams MS,Vaidya D,Kickler T,Ouyang P

doi

10.1016/j.ahj.2004.10.028

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

434-8

issue

3

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(04)00780-X

journal_volume

150

pub_type

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