Video Experimental Relacionado
Updated: Jun 27, 2026
06:18
An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
Estrógeno más progestina y riesgo de trombosis venosa
Mary Cushman1, Lewis H Kuller, Ross Prentice
1Department of Medicine, University of Vermont, Burlington 05446, USA. mary.cushman@uvm.edu
JAMA
|October 7, 2004
Resumen
La terapia hormonal posmenopáusica con estrógeno más progestina duplicó el riesgo de trombosis venosa. Esta terapia también amplificó los riesgos asociados con la edad, la obesidad y la mutación del Factor V Leiden.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Salud Cardiovascular La salud cardiovascular.
- Genética La genética.
Sus antecedentes:
- Se sabe que la terapia hormonal posmenopáusica aumenta el riesgo de trombosis venosa.
- El efecto acumulativo de la terapia hormonal con otros factores de riesgo de trombosis sigue sin estar claro.
Objetivo del estudio:
- Para presentar los datos finales sobre la incidencia de la trombosis venosa de la Iniciativa de Salud de la Mujer Estrógeno Más Progestina ensayo.
- Investigar la asociación entre la terapia hormonal y la trombosis venosa en el contexto de otros factores de riesgo.
Principales métodos:
- Un ensayo controlado aleatorizado, doble ciego, en el que participaron 16.608 mujeres posmenopáusicas de entre 50 y 79 años.
- Seguimiento de 5,6 años con un estudio de casos y controles anidados que analiza las variantes genéticas.
- Los participantes recibieron estrógeno equino conjugado más acetato de medroxiprogesterona o placebo.
Principales resultados:
- La trombosis venosa se produjo en 3,5/1000 personas-año con terapia hormonal frente a 1,7/1000 personas-año con placebo (HR, 2.06).
- El riesgo aumentó significativamente con la edad (HR 7,46 para 70-79 años) y el IMC (HR 5,61 para mujeres obesas).
- La mutación del factor V de Leiden amplificó notablemente el riesgo de trombosis asociado con la terapia hormonal (aumento de 6,69 veces).
Conclusiones:
- La terapia de estrógeno más progestina duplica aproximadamente el riesgo de trombosis venosa.
- La terapia hormonal exacerba los riesgos de trombosis relacionados con la edad avanzada, la obesidad y la mutación del Factor V Leiden.
Videos de Conceptos Relacionados
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...