doi: 10.1161/hc4401.98414
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2001;104:2300.)
© 2001 American Heart Association, Inc.
Clinical Investigations and Reports |
Hormone Therapy and In-Hospital Survival After Myocardial Infarction in Postmenopausal Women
From the General Internal Medicine Section, Veterans Affairs Medical Center (M.G.S., D.G.), and the Department of Medicine, University of California (M.G.S., B.G.A., A.S.G., D.G.), San Francisco; the Northern California Kaiser Division of Research (A.S.G.), Oakland, Calif; Ovation Research Group (P.D.F.), Chicago, Ill; and the University of Alabama Medical Center (J.G.C.), Birmingham, Ala.
Correspondence and reprint requests to Dr Michael G. Shlipak, General Internal Medicine Section, Veterans Affairs Medical Center (111A1), San Francisco, CA 94121. E-mail shlip{at}itsa.ucsf.edu
Background— Although postmenopausal hormone therapy (HRT) commonly is used in hope of preventing coronary heart disease, the effect of HRT on case fatality of myocardial infarction has never been studied. We evaluated HRT as a predictor of survival after MI in postmenopausal women.
Methods and Results— The present study was performed with 114 724 women of age 
55 years with confirmed myocardial infarction who presented between April 1998 and January 2000 to 1 of 1674 hospitals participating in the National Registry of Myocardial Infarction-3. Presenting characteristics, treatment, and clinical outcome data were obtained by chart review. At time of hospitalization, 7353 (6.4%) women reported current use of HRT, defined as use of estrogen, progestin, or estrogen/progestin for reasons other than contraception. Unadjusted mortality was 7.4% in users of HRT and 16.2% in nonusers (odds ratio 0.41, 95% confidence interval 0.36 to 0.43). After adjustments were made for prior medical history, clinical characteristics, treatments received in-hospital, and likelihood of receiving HRT, HRT remained associated with an improved rate of survival (odds ratio 0.65, 95% confidence interval 0.59 to 0.72). Significant association of HRT with decreased mortality after myocardial infarction was observed in all age strata.
Conclusions— Postmenopausal HRT appears to be associated with reduced mortality after myocardial infarction. This finding could be caused by therapeutic effect of HRT, selection and adherence bias, or some combination of both.
Key Words: women • hormones • myocardial infarction • survival
This article has been cited by other articles:
 |
|
 |
|
  E. Zhan, T. Keimig, J. Xu, E. Peterson, J. Ding, F. Wang, and X.-P. Yang Dose-dependent cardiac effect of oestrogen replacement in mice post-myocardial infarction Exp Physiol, August 1, 2008; 93(8): 982 - 993. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pedram, M. Razandi, D. Lubahn, J. Liu, M. Vannan, and E. R. Levin Estrogen Inhibits Cardiac Hypertrophy: Role of Estrogen Receptor-{beta} to Inhibit Calcineurin Endocrinology, July 1, 2008; 149(7): 3361 - 3369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.-M. Lee, M.-S. Lin, and N.-C. Chang Physiological Concentration of 17{beta}-Estradiol on Sympathetic Reinnervation in Ovariectomized Infarcted Rats Endocrinology, March 1, 2008; 149(3): 1205 - 1213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Collins, G. Rosano, C. Casey, C. Daly, M. Gambacciani, P. Hadji, R. Kaaja, T. Mikkola, S. Palacios, R. Preston, et al. Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and gynaecologists Eur. Heart J., August 2, 2007; 28(16): 2028 - 2040. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Peter, G. S. Huggins, A. M. Shearman, A. Pollak, C. H. Schmid, L. A. Cupples, S. Demissie, R. D. Patten, R. H. Karas, D. E. Housman, et al. Age-Related Changes in Echocardiographic Measurements: Association With Variation in the Estrogen Receptor-{alpha} Gene Hypertension, May 1, 2007; 49(5): 1000 - 1006. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Dawn and R. Bolli Increasing Evidence That Estrogen Is an Important Modulator of Bone Marrow-Mediated Cardiac Repair After Acute Infarction Circulation, November 21, 2006; 114(21): 2203 - 2205. [Full Text] [PDF]
|
|
|
|
|
|
H. Hamada, M. K. Kim, A. Iwakura, M. Ii, T. Thorne, G. Qin, J. Asai, Y. Tsutsumi, H. Sekiguchi, M. Silver, et al. Estrogen Receptors {alpha} and {beta} Mediate Contribution of Bone Marrow-Derived Endothelial Progenitor Cells to Functional Recovery After Myocardial Infarction Circulation, November 21, 2006; 114(21): 2261 - 2270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pedram, M. Razandi, M. Aitkenhead, and E. R. Levin Estrogen Inhibits Cardiomyocyte Hypertrophy in Vitro: ANTAGONISM OF CALCINEURIN-RELATED HYPERTROPHY THROUGH INDUCTION OF MCIP1 J. Biol. Chem., July 15, 2005; 280(28): 26339 - 26348. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Guo, M. Razandi, A. Pedram, G. Kassab, and E. R. Levin Estrogen Induces Vascular Wall Dilation: MEDIATION THROUGH KINASE SIGNALING TO NITRIC OXIDE AND ESTROGEN RECEPTORS {alpha} AND {beta} J. Biol. Chem., May 20, 2005; 280(20): 19704 - 19710. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. D. Patten, I. Pourati, M. J. Aronovitz, J. Baur, F. Celestin, X. Chen, A. Michael, S. Haq, S. Nuedling, C. Grohe, et al. 17{beta}-Estradiol Reduces Cardiomyocyte Apoptosis In Vivo and In Vitro via Activation of Phospho-Inositide-3 Kinase/Akt Signaling Circ. Res., October 1, 2004; 95(7): 692 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Xu, S. J. Armstrong, I. A. Arenas, D. J. Pehowich, and S. T. Davidge Cardioprotection by chronic estrogen or superoxide dismutase mimetic treatment in the aged female rat Am J Physiol Heart Circ Physiol, July 1, 2004; 287(1): H165 - H171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Herrington Hormone Replacement Therapy and Heart Disease: Replacing Dogma With Data Circulation, January 7, 2003; 107(1): 2 - 4. [Full Text] [PDF]
|
|
|
|
 |
|
 Women on HT May Have Better Survival Rates After Acute MI Journal Watch Women's Health, January 8, 2002; 2002(108): 6 - 6. [Full Text]
|
|