Venous thromboembolism in females in association with oral contraceptive use


Authors: P. Ďulíček 1;  P. Sadílek 1;  M. Beránek 2;  M. Pecka 1
Authors‘ workplace: IV. interní hematologická klinika, 2Oddělení klinické biochemie Fakultní nemocnice a Lékařská fakulta Univerzity Karlovy v Hradci Králové 1
Published in: Transfuze Hematol. dnes,19, 2013, No. 1, p. 33-38.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Venous thromboembolism (VTE) is a multifactorial disease and a major cause of morbidity and mortality. Pulmonary embolism in not only one risk factor, but also postrombotic syndrome can result in decrease quality of life. The incidence of VTE in the population is approximately 1 per 1 000 per year. Absolute risk of VTE is less than 1 per 10 000 per year in women of reproductive age. Pregnancy and oral contraceptive use are common risks of venous thromboembolism in this population (the absolute risk is 3 to 6 VTE/ 10 000 women on contraceptives per year). 33% of Czech women of reproductive age are on oral contraceptives. Risk of the onset of venous thrombosis depends on: duration of use, age of female, type use of contraceptive pill, obesity and is also increased in the case of inherited thrombophilia. We analysed a cohort of 400 Czech females with thrombosis in association with oral contraceptive use with the regard to mean age at the time of thrombosis, frequency of inherited and acquired thrombophilia, frequency of additional risk factors for VTE and duration of oral contraceptive use until the onset of thrombosis.

Key words:
venous thromboembolismus, hormonal contraceptive pill, thrombophilia


Sources

1. Nordström M, Lindblad B, Bergqvist D, Kjellström T. A prospective study of the incidence of deep – vein thrombosis within a defined urban population. J Intern Med 1992; 232:155-160.

2. Middeldorp S, Meijers JCM, van den Ende AE, et al. Effects on coagulation of levonorgestrel and desogestrel containing low dose oral contraceptives: a cross over study. Thromb Haemost 2000; 84: 4-8.

3. Rosendaal FR. Thrombosis in the young: Epidemiology and risk factors. A focus on venous thrombosis. Tromb Haemost 1997; 78:1-3.

4. Jordan WM. Pulmonary embolism. Lancet 1961; 278: 1146-1147.

5. Meade TW, Greenberg G, et al. Progestagens and cardiovascular reactions associated with oral contraceptives and comparison of the safety of 50-30 microgram oestrogen preparations. BMJ 1980; 280: 1157-1160.

6. Battiger LE, Boman G, Eklund G, Westerholm B. Oral contraceptives and thromboembolic disease: effects of lowering estrogen content. Lancet 1980; 1: 1097-1100.

7. Gerstman BB, Piper JM, Tomita DK, Ferguson WJ, Stadel BV, Lundin FE. Oral contraceptive estrogen dose and the risk of deep venous thromboembolism disease. Am J Epidemiol 1991; 133(1): 32-37.

8. World Health Organisation. Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet 1995; 346: 1575-1582.

9. Kemmeren JM, Algra A, Grobbee DE. Third generation oral contraceptives and risk of venous thrombosis: meta-analysis. Br Med J 2001; 323: 131-134.

10. Battaglioni T, Martinelli I. Hormone therapy and thromboembolic disease. Curr Opion Hematol 2007;14: 488-500.

11. Meijers JCM, Middeldorp S, Tekelenburg W, et al. Increased fibrinolytic activity during use of oral contraceptives is counteracted by an enhanced factor XI – independent down regulation of fibrinolysis. Tromb Haemost 2000; 84: 9-14.

12. Tans G, Curvers J, Middeldorp S, et al. A randomised a cross over study on the effects of levonorgestrel and desogestrel containing oral contraceptives on the anticoagulant pathways. Thromb Haemost 2000; 84: 15-21.

13. Abdollahi M, Cushman M, Rosendaal FR. Obesity: risk factors and oral contraceptive use. Thromb Haemost 2003; 89: 493-498.

14. Salden, A, Keeney S, Hay CRM, Cumming AM. The C677T variant and the risk of venous thrombosis (letter). Br J Haematol 1997; 99: 472.

15. Tosseto A, Missiaglia E, Frezzato M, Rodeghiero F. The VITA project: C677T mutation in the methylen-tetrahydrofolate reductase gene and the risk of venous thromboembolism. Br J Haematol 1997; 97: 804-806.

16. Brown K, Luddington R, Baglin T. Effect of the MTHFR C677T variant on the risk of venous thromboembolism: interaction with factor F V Leiden and prothrombin (F2G20210A) mutations. Br J Haematol 1998; 103: 42-44.

17. Simioni P, Sanson BJ, Prandoni P, et al. Incidence of venous thromboembolism in families with inherited thrombophilia. Thromb Haemost 1999; 81: 198-202.

18. Martinelli I, Mannucci PM, De Stefano V, et al. Different risk of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. Blood 1998; 92: 2353-2358.

19. Vandenbroucke JP, Koster T, Briët E, Reitsma PH, Bertina RM, Rosendaal FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet 1994; 344: 1453-1457.

20. Rosendaal FR, Koster T, Vandenbroucke JP, Reitsma PH. High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance). Blood 1995; 85: 1504-1508.

21. Rintelen C, Mannhalter C, Ireland H, et al. Oral contraceptives enhance the risk of clinical manifestation of venous thrombosis at a young age in females homozygous for factor V Leiden. Br J Haematol 1996; 93: 487-490.

22. Emmerich J, Rosendaal FR, Cattaneo M, et al. Combined effect of factor F V Leiden and prothrombin 20210A on the risk of venous thromboembolism-pooled analysis of 8 case-control studies including 2310 cases and 3204 controls. Study Group for Pooled-Analysis in Venous Thromboembolism. Thromb Haemost 2001; 86: 809-816.

23. Bloemenkamp KWM, Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Higher risk of venous thrombosis during early use of oral contraceptives in women with inherited clotting defects. Arch Intern Med 2000; 160: 49-52.

24. Herings RMC, Urquhart J, Leufkens HGM. Venous thromboembolism among new users of different oral contraceptives. Lancet 1999; 354: 127-128.

25. Dulíček P, Kalousek I. Hormonální antikoncepce a tromboembolická nemoc na konci tisíciletí. Plánování rodiny & reprodukční zdraví. 2000; 3: 60-62.

26. Dulíček P, Košťál M. Hormonální antikoncepce a tromboembolická nemoc, příručka pro praxi. Gynekologie po promoci-speciální vydání. 2002, ročník 2, 12.

27. Dinger JC, Heinemann LA, Kühl-Habich D, et al. The safety of a drospirenone-containing oral contraceptive, final results from the European Active Surveillance study on oral contraceptions based on 142,475 women-years of observation. Contraception 2007; 75: 344-347.

Labels
Haematology Internal medicine Clinical oncology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account