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Postmenopausal hormone use in women with acute coronary syndromes.

Publication ,  Journal Article
Parsons, E; Newby, LK; Bhapkar, MV; Alexander, KP; White, HD; Shah, SH; Bushnell, CD; Califf, RM; Symphony and 2nd Symphony Investigators,
Published in: J Womens Health (Larchmt)
October 2004

BACKGROUND: Recent trials reveal no benefit and possible harm from chronic hormone replacement therapy (HRT). Less is known about intermediate-term outcomes associated with HRT use in the setting of acute coronary syndromes (ACS). METHODS: To examine the prevalence of HRT use and relationships with intermediate-term outcomes among women with ACS, we classified as HRT users or nonusers 4029 postmenopausal women (age > 50 years or postmenopausal by case report form) randomized in the Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-Acute Coronary Syndromes (SYMPHONY) and 2nd SYMPHONY trials. Outcomes included 90-day and 1-year death and 90-day stroke, death, or myocardial infarction (MI); death, MI, or stroke; and death, MI, or severe recurrent ischemia (SRI). RESULTS: HRT use was 13% overall and varied by region (Asia, 0%; Eastern Europe, 0.2%; Latin America, 0.8%; Western Europe, 4%; Australia/New Zealand, 12%; Canada, 14%; United States, 24%); estrogen-only regimens were most common (90%). HRT users were younger, had higher estimated creatinine clearance, more frequently were smokers and had prior revascularization, but less frequently had diabetes, prior angina, or heart failure. Unadjusted 90-day and 1-year mortality rates were lower among HRT users (hazard ratios [95% CI] 0.48 [0.23-0.98] and 0.35 [0.18-0.68], respectively) but after multivariable adjustment, were not significantly different. Ninety-day stroke and composite end points did not differ between HRT users and nonusers. CONCLUSIONS: HRT use (predominantly estrogen-only) was low among patients with ACS but varied by region and was not associated with improved intermediate-term outcomes. These results are consistent with the absence of benefit from HRT use (combination or estrogen only) in previous studies in more stable populations.

Duke Scholars

Published In

J Womens Health (Larchmt)

DOI

ISSN

1540-9996

Publication Date

October 2004

Volume

13

Issue

8

Start / End Page

863 / 871

Location

United States

Related Subject Headings

  • Women's Health
  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Surveys and Questionnaires
  • Randomized Controlled Trials as Topic
  • Public Health
  • Prevalence
  • Postmenopause
  • Platelet Aggregation Inhibitors
 

Citation

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Parsons, E., Newby, L. K., Bhapkar, M. V., Alexander, K. P., White, H. D., Shah, S. H., … Symphony and 2nd Symphony Investigators, . (2004). Postmenopausal hormone use in women with acute coronary syndromes. J Womens Health (Larchmt), 13(8), 863–871. https://doi.org/10.1089/jwh.2004.13.863
Parsons, Elizabeth, L Kristin Newby, Manjushri V. Bhapkar, Karen P. Alexander, Harvey D. White, Svati H. Shah, Cheryl D. Bushnell, Robert M. Califf, and Robert M. Symphony and 2nd Symphony Investigators. “Postmenopausal hormone use in women with acute coronary syndromes.J Womens Health (Larchmt) 13, no. 8 (October 2004): 863–71. https://doi.org/10.1089/jwh.2004.13.863.
Parsons E, Newby LK, Bhapkar MV, Alexander KP, White HD, Shah SH, et al. Postmenopausal hormone use in women with acute coronary syndromes. J Womens Health (Larchmt). 2004 Oct;13(8):863–71.
Parsons, Elizabeth, et al. “Postmenopausal hormone use in women with acute coronary syndromes.J Womens Health (Larchmt), vol. 13, no. 8, Oct. 2004, pp. 863–71. Pubmed, doi:10.1089/jwh.2004.13.863.
Parsons E, Newby LK, Bhapkar MV, Alexander KP, White HD, Shah SH, Bushnell CD, Califf RM, Symphony and 2nd Symphony Investigators. Postmenopausal hormone use in women with acute coronary syndromes. J Womens Health (Larchmt). 2004 Oct;13(8):863–871.
Journal cover image

Published In

J Womens Health (Larchmt)

DOI

ISSN

1540-9996

Publication Date

October 2004

Volume

13

Issue

8

Start / End Page

863 / 871

Location

United States

Related Subject Headings

  • Women's Health
  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Surveys and Questionnaires
  • Randomized Controlled Trials as Topic
  • Public Health
  • Prevalence
  • Postmenopause
  • Platelet Aggregation Inhibitors