Endogenous thrombin potential changes during the first cycle of oral contraceptive use

Abstract Objectives Venous thromboembolism (VTE) risk increases within months of combination oral contraceptive (COC) initiation. Because elevated endogenous thrombin potential (ETP) has been found in several studies to be a VTE risk factor, we evaluated the extent of ETP changes during the initial...

Full description

Saved in:
Bibliographic Details
Published in:Contraception (Stoneham) 2017-05, Vol.95 (5), p.456-463
Main Authors: Westhoff, Carolyn L, Pike, Malcolm C, Cremers, Serge, Eisenberger, Andrew, Thomassen, Stella, Rosing, Jan
Format: Article
Language:English
Subjects:
Adult
Contraceptives, Oral, Combined - adverse effects
Contraceptives, Oral, Combined - blood
Endogenous thrombin potential
Ethinyl Estradiol - administration & dosage
Ethinyl Estradiol - adverse effects
Ethinyl Estradiol - pharmacokinetics
Female
Humans
Levonorgestrel - administration & dosage
Levonorgestrel - adverse effects
Levonorgestrel - pharmacokinetics
Obstetrics and Gynecology
Oral contraceptives
Protein C
Protein C - analysis
Risk Factors
Thrombin - analysis
Venous thromboembolism
Venous Thromboembolism - blood
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objectives Venous thromboembolism (VTE) risk increases within months of combination oral contraceptive (COC) initiation. Because elevated endogenous thrombin potential (ETP) has been found in several studies to be a VTE risk factor, we evaluated the extent of ETP changes during the initial cycle of an ethinyl estradiol (EE) and levonorgestrel (LNG) COC. We also assessed the relationship between ETP changes and systemic EE and LNG concentrations. Study design Participants provided multiple blood samples during a first 21-day cycle of a 30-mcg EE/150-mcg LNG COC and after a further 7 days without an active COC. Thrombin generation measured with and without addition of activated protein C (APC) yielded ETP+APC and ETP-APC and the normalized APC sensitivity ratio (nAPCsr). EE and LNG pharmacokinetic analyses were conducted over 24 h after the first COC tablet and again at steady state. Results Thrombin generation was determined in 16 of the 17 women who completed the study. Mean ETP-APC increased steadily to 21% above baseline at 24 h after the 6th COC tablet (COC624 ; p
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2017.01.001