Effect of Estrogen-Progestin Hormonal Replacement Therapy on Blood Coagulation and Fibrinolysis in Postmenopausal Women

Abstract

Tests were performed before (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of treatment. AT was determined by an amidolytic method, whereas F1+2 and TAT complex were measured by ELISA. RESULTS: There was a significant reduction in the AT level of patients who received oral CEE plus MP at T3. There was no AT reduction in patients taking either oral CEE alone or transdermal 17beta-estradiol plus MP. F1+2 increased in all patients, but it reached statistical significance only in patients receiving transdermal 17beta-estradiol MP at T3. CONCLUSIONS: The CEE associated with MP treatment may reduce AT levels, whereas unopposed CEE or transdermal 17beta-estradiol plus MP does not change AT. These changes might not be clinically relevant in the general population; however, hormonal replacement therapy may increase the risk of thrombosis in women with congenital or acquired thrombophilia.

Bovine pericardium retail preserved in glutaraldehyde and used as a vascular patch

“…In the group in which the flat edge of the retail was turned into the aorta this phenomenon was more intense on the suture line and was related to the roughness of the area and local release of thromboplastin by damaged tissues. Our results suggest that the wrinkled face of the retail would facilitate the capture and adhesion of blood components across its surface, with subsequent assemblage by the release of platelet factors and secondarily by thromboplastin released from damaged tissues [19]. We also verified that in this group there was the formation of a thin inner cover layer, resulting in dilatation of the patch area of surgery.…”

Prevention of Cardiovascular Risk Factors in Postmenopausal Women Receiving Transdermal Hormonal Replacement Therapy

“…Generally, Fib concentration in blood serum increases with age but this increase is smaller in women with hormonal replacement therapy in postmenopausal age [5,18,23,24,25].…”

“…According to many studies the influence of hormonal replacement therapies on C and S Proteins and AT III is different [2,5,6,7,12,18,24,26]. Some authors noted the increase of protein C and S [12,20] but others observed decrease of these natural coagulation inhibitors [Fishman et al 2003].…”

Progestogens and venous thromboembolism among postmenopausal women using hormone therapy

“…However, few studies, which most of them were randomized controlled trials, were adequately designed for assessing the effect of progestogens or for comparing the effect of a specific progestogen to each other on APCr, a validated surrogate marker of VTE and on F1+2 or Ddimers, first-generation biomarkers of coagulation and fibrinolysis [29,33,40,41,43,[47][48][49][50][51]53] (table 2). In addition, because postmenopausal women using progestogens are also prescribed estrogens, it is important to note that the influence of progestogens on haemostasis among postmenopausal women has been only investigated in a context of estrogens use.…”

“…On one hand, some data allowed assessing the main effect of some progestogens by comparing the changes in haemostasis between users of oral estrogens alone or combined with either micronized progesterone [51], dydrogesterone [33,40] , MPA [29,47,51], trimegestone [33,40] or gestodene [43]. Micronized progesterone, dydrogesterone, MPA and trimegestone may not induce significant changes in F1+2, DDimers and APCr related to oral estrogens use.…”