Estrogen replacement therapy and coagulation: Relationship to lipid and lipoprotein changes

Craig M. Kessler, Linda M. Szymanski, Zivar Shamsipour, Richard A. Muesing, Valery T. Miller, John C. Larosa

Research output: Contribution to journalArticle

Abstract

Objective: To examine the relationship of estrogen-induced changes in lipids and lipoproteins with alterations in the coagulation system. Methods: Coagulation and lipid indices were measured in 31 postmenopausal women, ages 40-60 years, after a 3-month course of 0.625-mg conjugated equine estrogen. We analyzed changes in variables from baseline to 3 months using t tests for paired samples or the Wilcoxon matched-pairs signed-rank test. Results: Unopposed estrogen replacement therapy produced statistically significant decreases in antithrombin-III antigen (P = .006) and activity (P = .001) and total protein S (P = .003) and a significant increase in protein C antigen (P = .017). C4b-binding protein also decreased significantly from baseline to 3 months (P <.001). Mean fibrinogen level decreased by 18.2 mg/dL, not a statistically significant change (P = .213). Estrogen produced the expected statistically significant changes in lipids and lipoproteins. Several correlations between changes in lipids and lipoproteins and coagulation indices were statistically significant. Protein C antigen and activity changes correlated directly with high-density lipoprotein cholesterol changes (r = .52, P ≤ .005; r = .38, P ≤ .05; respectively), and protein C antigen also correlated directly with increases in apoprotein A-I (r = .54, P ≤ .005). Triglyceride changes correlated directly with changes in protein C antigen (r = .36, P ≤ .05) and activity (r = .49, P ≤ .005) and inversely with C4b-binding protein (r = -.58, P ≤ .01). Apoprotein B was correlated with free protein S (r = .48, P ≤ .01). Conclusions: Although several estrogen-induced changes may decrease atherosclerotic potential and hypercoagulability, others may promote coagulability. These divergent effects may be manipulated pharmacologically by other estrogen compounds or by the addition of various progestins.

Original languageEnglish (US)
Pages (from-to)326-331
Number of pages6
JournalObstetrics and Gynecology
Volume89
Issue number3
DOIs
StatePublished - Mar 1997
Externally publishedYes

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Estrogen Replacement Therapy
Lipoproteins
Protein C
Lipids
Estrogens
Antigens
Complement C4b-Binding Protein
Protein S
Conjugated (USP) Estrogens
Apoproteins
Thrombophilia
Antithrombin III
Apolipoproteins B
Progestins
Fibrinogen
HDL Cholesterol
Triglycerides

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Kessler, C. M., Szymanski, L. M., Shamsipour, Z., Muesing, R. A., Miller, V. T., & Larosa, J. C. (1997). Estrogen replacement therapy and coagulation: Relationship to lipid and lipoprotein changes. Obstetrics and Gynecology, 89(3), 326-331. https://doi.org/10.1016/S0029-7844(96)00530-3

Estrogen replacement therapy and coagulation : Relationship to lipid and lipoprotein changes. / Kessler, Craig M.; Szymanski, Linda M.; Shamsipour, Zivar; Muesing, Richard A.; Miller, Valery T.; Larosa, John C.

In: Obstetrics and Gynecology, Vol. 89, No. 3, 03.1997, p. 326-331.

Research output: Contribution to journalArticle

Kessler, CM, Szymanski, LM, Shamsipour, Z, Muesing, RA, Miller, VT & Larosa, JC 1997, 'Estrogen replacement therapy and coagulation: Relationship to lipid and lipoprotein changes', Obstetrics and Gynecology, vol. 89, no. 3, pp. 326-331. https://doi.org/10.1016/S0029-7844(96)00530-3
Kessler, Craig M. ; Szymanski, Linda M. ; Shamsipour, Zivar ; Muesing, Richard A. ; Miller, Valery T. ; Larosa, John C. / Estrogen replacement therapy and coagulation : Relationship to lipid and lipoprotein changes. In: Obstetrics and Gynecology. 1997 ; Vol. 89, No. 3. pp. 326-331.
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AU - Muesing, Richard A.

AU - Miller, Valery T.

AU - Larosa, John C.

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