The objective of this study was to assess the risk of myocardial infarction (MI) associated with the use of new and old combination oral contraceptives (OC).
A matched case-control study in 16 centers in Germany, the United Kingdom, France, Austria, and Switzerland explored the association of current use of combination OC with the occurrence of MI.
Our subjects were 182 women aged 16-44 years with MI ; the controls were 635 women without MI (at least one hospital control and one community control per case) matched for 5-year age group and region.
The main outcome measures were odds ratios comparing current use of a specific group of OC against current use of other groups or against no current use.
The adjusted overall odds ratio (OR ; 95% confidence intervals) for MI for second generation OC versus no current use was 2.35 (1.42 to 3.89) and 0.82 (0.29 to 2.31) for third generation OC (low dose ethinyl estradiol, gestodene, and desogestrel).
A direct comparison of third generation users with second generation users yielded an OR of 0.28 (0.09 to 0.86).
In subgroup analyses, the odds ratio for the UK alone was 1.25 (0.36 to 4.29), while for continental Europe it was 0.10 (0.02 to 0.48).
For hospital controls, the risk estimated was 0.98 (0.22 to 4.44), and 0.18 (0.04 to 0.65) for community controls.
The independent risk of MI among current smokers adjusted for OC use was 7.21 (4.58 to 11.36).
Among users of third generation OC, the OR for current smokers was 3.75 (0. (...)
Mots-clés Pascal : Contraceptif, Voie orale, Epidémiologie, Toxicité, Infarctus, Myocarde, Homme, Femelle, Oestroprogestatif, Oestrogène, Progestatif, Gestodène, Désogestrel, Etude comparative, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Lévonorgestrel, Ethinylestradiol, Etude multicentrique, Progestatif troisième génération, Progestatif deuxième génération
Mots-clés Pascal anglais : Contraceptive, Oral administration, Epidemiology, Toxicity, Infarct, Myocardium, Human, Female, Estroprogestagen, Estrogen, Progestagen, Gestodene, Desogestrel, Comparative study, Cardiovascular disease, Coronary heart disease, Myocardial disease, Levonorgestrel, Ethinylestradiol, Multicenter study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0531838
Code Inist : 002B02U03. Création : 13/02/1998.