Third generation oral contraceptives and risk of myocardial infarction: an international case-control study

Abstract Objective: To test whether use of combined oral contraceptives containing third generation progestogens is associated with altered risk of myocardial infarction. Design: Matched case-control study. Setting: 16 centres in Austria, France, Germany, Switzerland, and the United Kingdom. Subject...

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Bibliographic Details
Published in:BMJ 1996-01, Vol.312 (7023), p.88-90
Main Authors: Lewis, Michael A, Spitzer, Walter O, Heinemann, Lothar A J, MacRae, Kenneth D, Bruppacher, Rudolf
Format: Article
Language:English
Subjects:
Biological and medical sciences
Birth control
Cardiovascular diseases
Case control studies
Confidence interval
Confidence intervals
Contraception
Drug toxicity and drugs side effects treatment
Epidemiology
Health risk assessment
Heart attacks
Hospitals
Medical research
Medical sciences
Methods
Myocardial infarction
Oral contraceptives
Pharmacology. Drug treatments
Ratios
Recruitment
Smoking
Studies
Thromboembolism
Toxicity: cardiovascular system
Transnationalism
Venous thrombosis
Womens health
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Summary:Abstract Objective: To test whether use of combined oral contraceptives containing third generation progestogens is associated with altered risk of myocardial infarction. Design: Matched case-control study. Setting: 16 centres in Austria, France, Germany, Switzerland, and the United Kingdom. Subjects: Cases were 153 women aged 16-44 with a myocardial infarction event. Controls were 498 women (at least 3 controls per case) unaffected by myocardial infarction who were matched with their corresponding case for age and for hospital or community setting within four months of the index infarction. Main outcome measures: Odds ratios derived with stratified analyses and unconditional logistic regression to adjust for potential confounding variables. Results: The estimated odds ratio for myocardial infarction of third compared with second generation oral contraceptives among all 651 study subjects was 0.36 (95% confidence interval 0.1 to 1.2) (P=0.11). The odds ratio for the United Kingdom and Germany alone was 0.45 (0.1 to 1.8) (P=0.26). Other odds ratios for the five countries were 3.1 (1.5 to 6.3) (P=0.003) for use of second generation products v no current use and 1.1 (0.4 to 3.4) (P=0.9) for use of third generation products v no current use. Among the confounding variables the independent contribution of smoking (for which adjustment was made in the above estimates) proved to be important (10.1 (5.7 to 17.9), P
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.312.7023.88