Past use of oral contraceptives and hormone replacement therapy in women with angiographic coronary artery disease: a case-control study

Abstract

To evaluate the relationship between past use of hormone replacement therapy (HRT)/ oral contraceptives (OC) and angiographic coronary artery disease (CAD). A case-control study. All women who were submitted to coronary angiography from January to December 2004 at the University Hospital, Ribeirão Preto School of Medicine (Brazil), were enrolled in this study and divided into two groups: with and without CAD. For the purposes of these analyses, coronary artery disease was defined as equal or greater than 70% luminal diameter stenosis in at least one epicardial coronary artery. The reproductive status was obtained from the medical records with a detailed questionnaire. We used unpaired t test, Fisher exact test or Qui-Square to compare the variables. Data were available for 203 of 383 patients who were submitted to angiocoronariography. Compared to patients without CAD (n = 119), patients with CAD (n = 84) were older (CAD: 62.8 ± 11.1 years vs. no-CAD 53.1 ± 12.1 years; P<0.0001), had a higher frequency of multiparity (CAD: 84% vs. no-CAD: 68%; P=0.03) and a higher proportion of them was menopausal (CAD:97% vs. no-CAD:79%; P=0.0009). The frequency of HRT use was higher among patients without CAD (CAD:28% vs. no-CAD:56%), with the use of HRT being associated with a lower risk for CAD [odds-ratio: 3.2 (1.2–8.3)]. The use of OC was not associated with a significant reduction of risk for CAD and the frequency of OC use did not differ between groups. There was no difference in the time of use of HRT or OC between CAD and no-CAD patients (HRT use: CAD = 4.9 ± 4.2 years vs. no-CAD = 2.7 ± 2.1 years; P=0.07; time of OC use: CAD = 8.8 ± 6.7 years vs. no-CAD = 6.1 ± 4.1 years; P=0.08). HRT but not OC use is associated with a reduced risk for CAD.