Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina.
Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina.
复制标题
急性激素治疗对患有不稳定心绞痛的绝经后妇女复发性缺血的影响。
DOI：
10.1016/s0735-1097(01)01724-7
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发表时间：
2002
影响因子：
24
通讯作者：
Gerstenblith,Gary
中科院分区：
文献类型：
--
作者：
Schulman,StevenP;Thiemann,DavidR;Ouyang,Pamela;Chandra,NishaC;Schulman,DouglasS;Reis,StevenE;Terrin,Michael;Forman,Sandra;deAlbuquerque,CiceroPiva;Bahr,RaymondD;Townsend,SusanN;Cosgriff,Rosalie;Gerstenblith,Gary
目的：我们测试了急性激素治疗是否减少绝经后（PMP）妇女不稳定型心绞痛（UA）的动态心电图缺血。急性雌激素管理改善PMP妇女与冠状动脉疾病的内皮功能，增加冠状动脉bloodflow.MethodsTwo 93 PMP妇女UA（平均年龄69.7岁），标准的抗缺血治疗，在24小时内症状发作。以双盲方式，受试者随机接受静脉注射后口服结合雌激素21天，静脉注射雌激素后口服结合雌激素加甲羟孕酮21天或安慰剂。主要终点是最初48小时内动态心电图缺血事件的数量。临床事件也确定了超过6个月的follow-up.ResultsElectrocardiographic缺血没有不同的三个随机分组。雌激素组每例患者48小时内缺血事件的平均数为0.74，雌激素+孕激素组为0.86，安慰剂组为0.74（p = 0.87）。激素治疗组和安慰剂治疗组发生缺血事件的患者百分比和缺血的平均持续时间无差异。在医院和6个月的不良临床事件的发生率也相似的三个随机groups.ConclusionsAcute激素治疗不减少缺血性PMP妇女UA时，添加到标准的抗缺血治疗。
ObjectivesWe tested whether acute hormone therapy reduces ambulatory electrocardiographic ischemia in postmenopausal (PMP) women with unstable angina (UA).BackgroundEndothelial dysfunction contributes to the pathophysiology of UA. Acute estrogen administration improves endothelial function in PMP women with coronary artery disease and increases coronary artery blood flow.MethodsTwo hundred ninety-three PMP women with UA (mean age 69.7 years), treated with standard anti-ischemic therapy, were enrolled within 24 h of symptom onset. In a double-blind fashion, subjects were randomized to receive intravenous followed by oral conjugated estrogen for 21 days, intravenous estrogen followed by oral conjugated estrogen plus medroxyprogesterone for 21 days or placebo. The primary end point was the number of ambulatory electrocardiographic ischemic events over the first 48 h. Clinical events were also determined over six months of follow-up.ResultsElectrocardiographic ischemia did not differ among the three randomized groups. The mean number of ischemic events per patient over 48 h was 0.74 for estrogen, 0.86 for estrogen plus progesterone and 0.74 for the placebo groups (p = 0.87). The percentage of patients with ischemic events and the mean duration of ischemia did not differ between hormone- and placebo-treated patients. In-hospital and six-month rates of adverse clinical events were also similar among the three randomized groups.ConclusionsAcute hormone therapy does not reduce ischemia in PMP women with UA when added to standard anti-ischemic therapy.