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Published on: May 25, 2020
Noncontraceptive estrogens and nonfatal myocardial infarction
JAMA
|April 3, 1978
Summary
Estrogen use significantly increases the risk of acute myocardial infarction in women over 38 who also smoke. This finding highlights a substantial risk for this demographic group.
Area of Science:
- Cardiology
- Women's Health
- Pharmacology
Background:
- Acute myocardial infarction (AMI) is uncommon in young, healthy women.
- Factors contributing to AMI in this demographic are not fully understood.
Purpose of the Study:
- To investigate the association between noncontraceptive estrogen use and AMI in premenopausal women.
- To identify risk factors for AMI in women under 46 years old.
Main Methods:
- Retrospective case series analysis of 107 women under 46 hospitalized with AMI.
- Comparison of estrogen use and smoking habits between patients and controls.
Main Results:
- 17 women (aged 39-45) with AMI were analyzed; 9 (53%) used noncontraceptive estrogens.
- Estrogen users had a relative risk of 7.5 for AMI compared to nonusers.
- All but one of the 17 patients were cigarette smokers.
Conclusions:
- Noncontraceptive estrogen use is associated with a substantial increase in AMI risk for women over 38 who smoke.
- Combined estrogen use and smoking represent a significant risk factor for AMI in this population.
- Further research is warranted to elucidate mechanisms and inform clinical guidelines.
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