Association between hormone replacement therapy and subsequent arterial and venous vascular events: a meta-analysis.
Association between hormone replacement therapy and subsequent arterial and venous vascular events: a meta-analysis.
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DOI：
10.1093/eurheartj/ehn299
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发表时间：
2008-08
影响因子：
39.3
通讯作者：
Bath PM
中科院分区：
文献类型：
--
作者：
Sare GM;Gray LJ;Bath PM
随机对照试验（RCTs）显示，激素替代疗法（HRT）会增加卒中和静脉血栓栓塞（VTE）的风险；对冠心病（CHD）的影响尚不清楚。确定了HRT的随机对照试验。分析脑血管疾病（脑卒中、短暂性脑缺血发作）、冠心病（心肌梗死、不稳定型心绞痛、心源性猝死）和VTE（肺栓塞、深静脉血栓形成）的发生率。敏感性分析按HRT类型（单药vs双药）和受试者年龄进行。共纳入31项试验（44113名受试者）。HRT与卒中（比值比，OR, 1.32, 95%可信区间，CI, 1.14-1.53）和静脉血栓栓塞（OR, 2.05, 95% CI, 1.44-2.92）的增加相关。相比之下，冠心病事件没有增加（OR 1.02, 95% CI 0.90-1.11）。序贯分析证实，HRT增加了卒中严重程度（OR 1.31, 95% CI 1.12-1.54）。尽管大多数试验都包括老年受试者，但年龄对风险没有显著影响。在雌激素的基础上添加黄体酮会使静脉血栓栓塞的风险增加一倍。HRT与卒中、卒中严重程度和静脉血栓栓塞的风险增加有关，但与冠心病事件无关。尽管大多数试验研究的是老年患者，但风险增加与年龄无关。与雌激素单药治疗相比，联合HRT增加静脉血栓栓塞的风险。
Randomized controlled trials (RCTs) have shown that the risk of stroke and venous thromboembolism (VTE) is increased with hormone replacement therapy (HRT); the effect on coronary heart disease (CHD) remains unclear. RCTs of HRT were identified. Event rates for cerebrovascular disease [stroke, TIA (transient ischaemic attack)], CHD (myocardial infarction, unstable angina, sudden cardiac death), and VTE (pulmonary embolism, deep vein thrombosis) were analysed. Sensitivity analyses were performed by type of HRT (mono vs. dual) and subject age. 31 trials (44 113 subjects) were identified. HRT was associated with increases in stroke (odds ratio, OR, 1.32, 95% confidence intervals, CI, 1.14–1.53) and VTE (OR 2.05, 95% CI 1.44–2.92). In contrast, CHD events were not increased (OR 1.02, 95% CI 0.90–1.11). Ordinal analyses confirmed that stroke severity was increased with HRT (OR 1.31, 95% CI 1.12–1.54). Although most trials included older subjects, age did not significantly affect risk. The addition of progesterone to oestrogen doubled the risk of VTE. HRT is associated with an increased risk of stroke, stroke severity, and VTE, but not of CHD events. Although most trials studied older patients, increased risk was not related to age. Combined HRT increases the risk of VTE compared with oestrogen monotherapy.
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DOI：
10.1196/annals.1365.031
发表时间：
2006-01-01
期刊：
WOMEN'S HEALTH AND DISEASE: GYNECOLOGIC, ENDOCRINE, AND REPRODUCTIVE ISSUES
影响因子：
--
作者：
Rosano, Giuseppe M. C.;Vitale, Cristiana;Fini, Massimo
通讯作者：
Fini, Massimo
影响因子：
168.9
作者：
Moher, D;Pham, B;Klassen, TP
通讯作者：
Klassen, TP
影响因子：
--
作者：
HALL, GM;DANIELS, M;SPECTOR, TD
通讯作者：
SPECTOR, TD
影响因子：
7.7
作者：
Kim, J;Evans, S;Pocock, S
通讯作者：
Pocock, S
影响因子：
2
作者：
Higgins, JPT;Thompson, SG
通讯作者：
Thompson, SG