Clotting Mechanisms in Patients with Hypertriglyceridemia during Therapy with Anabolic or Progestational Drugs

Abstract

SummaryEffects of synthetic steroids with progestational and androgenic-anabolic activity (Norethindrone Acetate and Oxandrolone) on coagulation parameters and plasma lipids were studied in 20 patients with familial types III, IV and V hyperlipoproteinemia. Prior to therapy there was a relatively uniform elevation of fibrinogen (284 mg %) and esterase prothrombin (64 U/ml). On therapy mean fibrinogen fell sharply to 223 mg % (short-term) and 195 mg % long-term. There were no increments in other clotting factors, and levels of factor VII and X were decreased on drug in several patients who initially had abnormally high levels. The fall in fibrinogen on therapy did not correlate with concurrent decrements in cholesterol or triglyceride. In hypertriglyceridemic patients predisposed to coronary or peripheral vascular thrombosis, Norethindrone and Oxandrolone appear to ameliorate rather than potentiate any tendency to “hypercoagulability”.