Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study

Ditte-Marie Bretler, P. R. Hansen, S. Z. Abildstrom, C. H. Jorgensen, R. Sorensen, M. L. Hansen, Tina Ken Schramm, E. Lokkegaard, Christian Tobias Torp-Pedersen, Gunnar Hilmar Gislason

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    center dot General use of hormone replacement therapy (HRT) dropped drastically after 2002 when pivotal randomized trials showed increased risk of coronary artery disease and other complications with HRT. center dot HRT is not recommended for primary or secondary prevention of coronary heart disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). center dot It is unknown whether women actually discontinue HRT after MI. WHAT THIS STUDY ADDS center dot Women who use HRT when they experience their MI generally continue using HRT. center dot We found a remarkably low increase in discontinuation after 2002, in contrast to the general drop in use of HRT. AIM To characterize the pattern of use and discontinuation of postmenopausal hormone replacement therapy (HRT) in women with myocardial infarction (MI) before and after 2002, where the general use of HRT dropped drastically subsequent to the results of the Women's Health Initiative trial. METHODS All Danish women aged >= 40 years hospitalized with MI in the period 1997 to 2005 and their use of HRT were identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. Characteristics associated with HRT use at time of MI and subsequent HRT discontinuation were analysed by multivariable logistic regression. RESULTS In the study period, 34 778 women were discharged after MI. Of these, 3979 (11.4%) received HRT at the time of MI and their most used categories of HRT were vaginal oestrogen and oral oestrogen alone (46.6% and 28.7%, respectively). The percentage of women who continued HRT during the first year after discharge was 85.0% in the period 2000-2002 and had decreased to 79.6% in the period 2003-2005. Vaginal oestrogen use was associated with overall discontinuation of HRT (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.10, 1.72), whereas use of oral oestrogen alone and use of oral cyclic combined oestrogen/progestogen were associated with change of HRT after MI (OR 2.33, 95% CI 1.10, 4.93 and OR 2.94, 95% CI 1.35, 6.39, respectively). CONCLUSION The majority of women experiencing an MI during ongoing HRT continued HRT after discharge and this pattern of HRT use did not change markedly after 2002.
    OriginalsprogEngelsk
    TidsskriftBritish Journal of Clinical Pharmacology
    Vol/bind71
    Udgave nummer1
    Sider (fra-til)105-115
    Antal sider11
    ISSN0306-5251
    DOI
    StatusUdgivet - 2011

    Citer dette

    Bretler, D-M., Hansen, P. R., Abildstrom, S. Z., Jorgensen, C. H., Sorensen, R., Hansen, M. L., ... Gislason, G. H. (2011). Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study. British Journal of Clinical Pharmacology, 71(1), 105-115. https://doi.org/10.1111/j.1365-2125.2010.03790.x
    Bretler, Ditte-Marie ; Hansen, P. R. ; Abildstrom, S. Z. ; Jorgensen, C. H. ; Sorensen, R. ; Hansen, M. L. ; Schramm, Tina Ken ; Lokkegaard, E. ; Torp-Pedersen, Christian Tobias ; Gislason, Gunnar Hilmar. / Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study. I: British Journal of Clinical Pharmacology. 2011 ; Bind 71, Nr. 1. s. 105-115.
    @article{3969cd07776c45c187429543eb75bba1,
    title = "Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study",
    abstract = "center dot General use of hormone replacement therapy (HRT) dropped drastically after 2002 when pivotal randomized trials showed increased risk of coronary artery disease and other complications with HRT. center dot HRT is not recommended for primary or secondary prevention of coronary heart disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). center dot It is unknown whether women actually discontinue HRT after MI. WHAT THIS STUDY ADDS center dot Women who use HRT when they experience their MI generally continue using HRT. center dot We found a remarkably low increase in discontinuation after 2002, in contrast to the general drop in use of HRT. AIM To characterize the pattern of use and discontinuation of postmenopausal hormone replacement therapy (HRT) in women with myocardial infarction (MI) before and after 2002, where the general use of HRT dropped drastically subsequent to the results of the Women's Health Initiative trial. METHODS All Danish women aged >= 40 years hospitalized with MI in the period 1997 to 2005 and their use of HRT were identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. Characteristics associated with HRT use at time of MI and subsequent HRT discontinuation were analysed by multivariable logistic regression. RESULTS In the study period, 34 778 women were discharged after MI. Of these, 3979 (11.4{\%}) received HRT at the time of MI and their most used categories of HRT were vaginal oestrogen and oral oestrogen alone (46.6{\%} and 28.7{\%}, respectively). The percentage of women who continued HRT during the first year after discharge was 85.0{\%} in the period 2000-2002 and had decreased to 79.6{\%} in the period 2003-2005. Vaginal oestrogen use was associated with overall discontinuation of HRT (odds ratio [OR] 1.37, 95{\%} confidence interval [CI] 1.10, 1.72), whereas use of oral oestrogen alone and use of oral cyclic combined oestrogen/progestogen were associated with change of HRT after MI (OR 2.33, 95{\%} CI 1.10, 4.93 and OR 2.94, 95{\%} CI 1.35, 6.39, respectively). CONCLUSION The majority of women experiencing an MI during ongoing HRT continued HRT after discharge and this pattern of HRT use did not change markedly after 2002.",
    author = "Ditte-Marie Bretler and Hansen, {P. R.} and Abildstrom, {S. Z.} and Jorgensen, {C. H.} and R. Sorensen and Hansen, {M. L.} and Schramm, {Tina Ken} and E. Lokkegaard and Torp-Pedersen, {Christian Tobias} and Gislason, {Gunnar Hilmar}",
    year = "2011",
    doi = "10.1111/j.1365-2125.2010.03790.x",
    language = "English",
    volume = "71",
    pages = "105--115",
    journal = "British Journal of Clinical Pharmacology",
    issn = "0306-5251",
    publisher = "Wiley-Blackwell",
    number = "1",

    }

    Bretler, D-M, Hansen, PR, Abildstrom, SZ, Jorgensen, CH, Sorensen, R, Hansen, ML, Schramm, TK, Lokkegaard, E, Torp-Pedersen, CT & Gislason, GH 2011, 'Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study', British Journal of Clinical Pharmacology, bind 71, nr. 1, s. 105-115. https://doi.org/10.1111/j.1365-2125.2010.03790.x

    Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study. / Bretler, Ditte-Marie; Hansen, P. R.; Abildstrom, S. Z.; Jorgensen, C. H.; Sorensen, R.; Hansen, M. L.; Schramm, Tina Ken; Lokkegaard, E.; Torp-Pedersen, Christian Tobias; Gislason, Gunnar Hilmar.

    I: British Journal of Clinical Pharmacology, Bind 71, Nr. 1, 2011, s. 105-115.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study

    AU - Bretler, Ditte-Marie

    AU - Hansen, P. R.

    AU - Abildstrom, S. Z.

    AU - Jorgensen, C. H.

    AU - Sorensen, R.

    AU - Hansen, M. L.

    AU - Schramm, Tina Ken

    AU - Lokkegaard, E.

    AU - Torp-Pedersen, Christian Tobias

    AU - Gislason, Gunnar Hilmar

    PY - 2011

    Y1 - 2011

    N2 - center dot General use of hormone replacement therapy (HRT) dropped drastically after 2002 when pivotal randomized trials showed increased risk of coronary artery disease and other complications with HRT. center dot HRT is not recommended for primary or secondary prevention of coronary heart disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). center dot It is unknown whether women actually discontinue HRT after MI. WHAT THIS STUDY ADDS center dot Women who use HRT when they experience their MI generally continue using HRT. center dot We found a remarkably low increase in discontinuation after 2002, in contrast to the general drop in use of HRT. AIM To characterize the pattern of use and discontinuation of postmenopausal hormone replacement therapy (HRT) in women with myocardial infarction (MI) before and after 2002, where the general use of HRT dropped drastically subsequent to the results of the Women's Health Initiative trial. METHODS All Danish women aged >= 40 years hospitalized with MI in the period 1997 to 2005 and their use of HRT were identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. Characteristics associated with HRT use at time of MI and subsequent HRT discontinuation were analysed by multivariable logistic regression. RESULTS In the study period, 34 778 women were discharged after MI. Of these, 3979 (11.4%) received HRT at the time of MI and their most used categories of HRT were vaginal oestrogen and oral oestrogen alone (46.6% and 28.7%, respectively). The percentage of women who continued HRT during the first year after discharge was 85.0% in the period 2000-2002 and had decreased to 79.6% in the period 2003-2005. Vaginal oestrogen use was associated with overall discontinuation of HRT (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.10, 1.72), whereas use of oral oestrogen alone and use of oral cyclic combined oestrogen/progestogen were associated with change of HRT after MI (OR 2.33, 95% CI 1.10, 4.93 and OR 2.94, 95% CI 1.35, 6.39, respectively). CONCLUSION The majority of women experiencing an MI during ongoing HRT continued HRT after discharge and this pattern of HRT use did not change markedly after 2002.

    AB - center dot General use of hormone replacement therapy (HRT) dropped drastically after 2002 when pivotal randomized trials showed increased risk of coronary artery disease and other complications with HRT. center dot HRT is not recommended for primary or secondary prevention of coronary heart disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). center dot It is unknown whether women actually discontinue HRT after MI. WHAT THIS STUDY ADDS center dot Women who use HRT when they experience their MI generally continue using HRT. center dot We found a remarkably low increase in discontinuation after 2002, in contrast to the general drop in use of HRT. AIM To characterize the pattern of use and discontinuation of postmenopausal hormone replacement therapy (HRT) in women with myocardial infarction (MI) before and after 2002, where the general use of HRT dropped drastically subsequent to the results of the Women's Health Initiative trial. METHODS All Danish women aged >= 40 years hospitalized with MI in the period 1997 to 2005 and their use of HRT were identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. Characteristics associated with HRT use at time of MI and subsequent HRT discontinuation were analysed by multivariable logistic regression. RESULTS In the study period, 34 778 women were discharged after MI. Of these, 3979 (11.4%) received HRT at the time of MI and their most used categories of HRT were vaginal oestrogen and oral oestrogen alone (46.6% and 28.7%, respectively). The percentage of women who continued HRT during the first year after discharge was 85.0% in the period 2000-2002 and had decreased to 79.6% in the period 2003-2005. Vaginal oestrogen use was associated with overall discontinuation of HRT (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.10, 1.72), whereas use of oral oestrogen alone and use of oral cyclic combined oestrogen/progestogen were associated with change of HRT after MI (OR 2.33, 95% CI 1.10, 4.93 and OR 2.94, 95% CI 1.35, 6.39, respectively). CONCLUSION The majority of women experiencing an MI during ongoing HRT continued HRT after discharge and this pattern of HRT use did not change markedly after 2002.

    U2 - 10.1111/j.1365-2125.2010.03790.x

    DO - 10.1111/j.1365-2125.2010.03790.x

    M3 - Journal article

    VL - 71

    SP - 105

    EP - 115

    JO - British Journal of Clinical Pharmacology

    JF - British Journal of Clinical Pharmacology

    SN - 0306-5251

    IS - 1

    ER -