Estrogen replacement therapy and prognosis after first myocardial infarction.
Estrogen replacement therapy and prognosis after first myocardial infarction.
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首次心肌梗死后的雌激素替代治疗和预后。
DOI：
10.1093/oxfordjournals.aje.a009100
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发表时间：
1997
影响因子：
5
通讯作者：
Weiss,NS
中科院分区：
文献类型：
--
作者：
Newton,KM;LaCroix,AZ;McKnight,B;Knopp,RH;Siscovick,DS;Heckbert,SR;Weiss,NS
雌激素替代治疗对已确诊冠心病妇女预后的影响尚不确定。作者对1980年至1991年在华盛顿州西部普吉特湾团体健康合作社登记的726名首次心肌梗死存活至出院的妇女（平均年龄66.2岁）进行了回顾性队列研究。雌激素替代治疗后心肌梗死（122名妇女）确定从计算机药房记录。确定了1993年的再梗死（n= 135）和死亡（n= 183），并计算了相对风险。校正年龄和梗死后时间后，心肌梗死后当前雌激素替代治疗相关的再梗死相对风险为0.64（95%置信区间（CI）0.32-1.30），既往雌激素替代治疗相关的再梗死相对风险为0.90（95% CI 0.62-1.31）。与当前雌激素替代治疗相关的全因死亡率的相对nsk为0.50（95% CI 0.25 -1.00），与既往雌激素替代治疗相关的全因死亡率的相对nsk为0.79（95% CI 0.56-1.09）。虽然雌激素使用者比非使用者更不可能有糖尿病或充血性心力衰竭史，但调整这些和其他预后因素仅轻微改变风险估计。首次心肌梗死后的雌激素替代治疗与再梗死风险或死亡率增加无关。这项研究为女性心肌梗死后雌激素替代治疗的安全性提供了保证。美国流行病学杂志1997; 145：269-77。
The effects of estrogen replacement therapy on prognosis in women with established coronary disease remain uncertain. The authors conducted a retrospective cohort study of 726 women (mean age, 66.2 years) who survived first myocardial infarction to hospital discharge from 1980 through 1991, while enrolled at Group Health Cooperative of Puget Sound in western Washington State. Estrogen replacement therapy after myocardial infarction (122 women) was ascertained from computerized pharmacy records. Reinfarctions (n= 135) and deaths (n= 183) through 1993 were identified, and relative risks were calculated. The relative risk for reinfarction associated with current estrogen replacement therapy after myocardial infarction, adjusting for age and time since infarction, was 0.64 (95% confidence interval (Cl) 0.32–1.30), and that for past estrogen replacement therapy was 0.90 (95% Cl 0.62–1.31). The relative nsk for all-cause mortality associated with current estrogen replacement therapy was 0.50 (95% Cl 0 25–1.00), and that for past estrogen replacement therapy was 0.79 (95% Cl 0.56–1.09). While estrogen users were less likely than nonusers to have a history of diabetes or congestive heart failure, adjustment for these and additional prognostic factors altered risk estimates only slightly. Estrogen replacement therapy after first myocardial infarction was not associated with increased risk of reinfarction or mortality. This study provides reassurance regarding the safety of estrogen replacement therapy after myocardial infarction in women.Am J Epidemiol1997; 145: 269-77.