doi: 10.1161/hc0102.104536
(Circulation. 2002;105:e9063.)
© 2002 American Heart Association, Inc.
Cardiovascular News
Circulation Newswriter
Myocardial Infarction and Oral Contraceptives
The association between myocardial infarction and the use of oral contraceptives appears to be a real one, even increasing in second-generation drugs, said authors from the Netherlands in an article in the December 20, 2001, issue of The New England Journal of Medicine (N Engl J Med. 2001;345:1787–1793). The risk appears to decrease, however, in third-generation birth control pills, according to Bea C. Tanis, MD, and co-authors from the Leiden University Medical Center in Leiden and the University Medical Center in Utrecht.
In their population-based, case-control study, the authors enrolled 248 women ages 18 through 49 years of age who had had a first myocardial infarction between the years 1990 and 1995, as well as 925 control women. Subjects were matched for age, calendar year of the index event, and area of residence. The women supplied information about their use of oral contraceptives and major cardiovascular risk factors. The authors also analyzed the women’s DNA for the presence of factor V Leiden and the G20210A mutation in the prothrombin gene.
They found that that odds ratio of myocardial infarction among the women who used any type of combined oral contraceptive when compared with those who did not use oral contraceptives was 2.0. The adjusted odds ratio was 2.5 among women who used second-generation oral contraceptives, but only 1.3 among those who used third-generation pills. The odds ratio was 2.1 for those who lacked a prothrombotic mutation and 1.9 for those with a mutation.
The authors concluded that the