A prospective study of oral contraceptive use and risk of myocardial infarction among Swedish women
- From: MarilynMann <mannm@xxxxxxxxxxx>
- Date: Tue, 11 Sep 2007 18:15:39 -0700
Fertility and Sterility
Volume 88, Issue 2, August 2007, Pages 310-316
A prospective study of oral contraceptive use and risk of myocardial
infarction among Swedish women
Karen L. Margolis M.D.a, , , Hans-Olov Adami M.D.b, Juhua Luo M.S.b,
Weimin Ye M.D.b and Elisabete Weiderpass M.D.b, c
aHealthPartners Research Foundation, Minneapolis, Minnesota
bDepartment of Medical Epidemiology and Biostatistics, Karolinska
Institutet, Stockholm, Sweden
cThe Cancer Registry of Norway, Oslo, Norway
Objective
To determine the risk for incident myocardial infarction (MI) in women
exposed to modern formulations of oral contraceptives (OCs).
Design
Population-based, prospective cohort study begun in 1991 with follow-
up through 2002 for an average of 11 years.
Patient(s)
A total of 48,321 Swedish women aged 30-49 randomly selected from the
population residing in the Uppsala Health Care Region of Sweden in
1990-91.
Main Outcome Measure(s)
Fatal and nonfatal MI ascertained through linkages with nationwide
health registries for death, hospitalization, and emigration.
Result(s)
There were 214 incident cases of MI. Compared with never users,
neither former (relative risk, 1.0; 95% confidence interval, 0.7-1.4)
nor current (relative risk, 0.7; 95% confidence interval, 0.4-1.4) OC
users at study enrollment had an elevated risk of future MI in models
adjusted for coronary heart disease risk factors. Risk of MI was not
elevated by prolonged use or in subgroups defined by characteristics
of the women or types of OC.
Conclusion(s)
Use of OC was not associated with an increased risk of MI in this
prospective study, in which most current users of OC were taking low-
dose estrogen and second- or third-generation progestins.
Supported by the Swedish Council for Planning and coordination of
Research, Swedish Cancer Society, Swedish Medical Products Agency,
Organon, Pharmacia, and Schering-Plough. Dr. Margolis received support
from awards from the National Heart, Lung and Blood Institute (K23
HL03996) and from the University of Minnesota International Medical
Education and Research Program. None of the funders was involved in
the design or conduct of the study; collection, management, analysis,
or interpretation of data; or preparation, review, or approval of the
manuscript.
Correspondence to: Karen L. Margolis, M.D., M.P.H., HealthPartners
Research Foundation, P.O. Box 1524, Mail Stop 21111R, Minneapolis, MN
55440-1524 (FAX: 952-967-5022).
.
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