| アブストラクト | OBJECTIVE: To compare the rate of arterial thromboembolism (ATE) of drospirenone-containing COCs to that of levonorgestrel-containing COCs. DESIGN: Population-based cohort study. SETTING: United Kingdom's Clinical Practice Research Datalink (CPRD), which contains clinical records for >11 million patients. POPULATION: Women aged 16-45 years prescribed a drospirenone- or levonorgestrel-containing COC between May 2002 and June 2012. METHODS: We conducted nested case-control analyses using risk set sampling to randomly select up to 10 controls for each ATE case, matched on age, cohort entry year, CPRD registration year, COC user type (first-time ever, new, switcher, or prevalent users), duration of COC use, duration of progestin-only or implantable contraceptive use, pre-cohort entry duration of drospirenone and levonorgestrel use, and duration of follow up. MAIN OUTCOME MEASURES: We used conditional logistic regression to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for high-dimensional propensity scores. RESULTS: Our cohort included 339 743 women followed over a mean 4.4 years, during which 228 ATE cases occurred: 37 myocardial infarctions, 170 strokes, and 21 other ATEs; overall rate: 1.5 events per 10 000 person-years (PYs). After adjusting for potential confounders, the hazard ratio for ATE with current use of drospirenone-containing COCs versus current use of levonorgestrel-containing COCs was 0.89 (95% CI 0.35, 2.28), corresponding to a rate difference of -0.16 events per 10 000 PYs. CONCLUSIONS: The overall rate of ATE in this population is low regardless of which COC was taken. We found little evidence of a difference in the rate of ATE with drospirenone- versus levonorgestrel-containing COCs. TWEETABLE ABSTRACT: Little evidence was found of a greater incidence of arterial thrombosis with drospirenone versus levonorgestrel contraceptives. |
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| ジャーナル名 | BJOG : an international journal of obstetrics and gynaecology |
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| 投稿日 | 2016/10/6 |
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| 投稿者 | Larivee, N; Suissa, S; Eberg, M; Joseph, L; Eisenberg, M J; Abenhaim, H A; Filion, K B |
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| 組織名 | Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;Montreal, Quebec, Canada.;Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Quebec, Canada.;Division of Clinical Epidemiology, Department of Medicine, McGill University,;Division of Clinical Epidemiology, McGill University Health Centre, Montreal,;Quebec, Canada.;Division of Cardiology, Jewish General Hospital, McGill University, Montreal,;Department of Obstetrics and Gynecology, Jewish General Hospital, McGill |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27704723/ |
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