Heart 1998;80:235-239 ( September )
Fibrinolytic potential is significantly increased by oestrogen treatment in postmenopausal women with mild dyslipidaemia
a Institute for
Prevention of Cardiovascular Disease, Cardiovascular Division, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston,
Massachusetts, USA, b Department of Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston,
Massachusetts, USA, c Heart Institute, School of Medicine, University
of São Paulo, Brazil, d Kentucky
Clinic, University of Kentucky Medical Center, Lexington, Kentucky, USA
Correspondence to: Dr G H Tofler, Institute for Prevention of Cardiovascular Disease, Deaconess Hospital, One Autumn Street, 5th floor, Boston, MA 02215, USA. email: gtofler{at}bidmc.harvard.edu
Accepted for publication 24 April 1998
Objective
To
study the effects of oestrogen replacement treatment on fibrinolytic
potential in postmenopausal women.
DesignRandomised,
double blind, placebo controlled trial of oral 17
-oestradiol.
SettingSubjects were
evaluated in the outpatient setting.
PatientsNineteen
postmenopausal women with mild dyslipidaemia, aged 44 to 69 years (mean
(SD) 55.7 (6.7)).
Main outcome
measuresFibrinolytic activity (fibrin
plate assay) and tissue plasminogen activator (t-PA) antigen were
measured at baseline and after three, six, and nine weeks of each treatment.
ResultsAfter nine
weeks of 2 mg oestradiol treatment, there was a significant increase
in fibrinolytic potential compared with placebo, as indicated by an
increase in fibrinolytic activity (mean (SEM), 80 (9)
v 54 (5) mm2 of lysis in the
fibrin plate, 2 mg v placebo, p = 0.002)
and a decrease in t-PA antigen (5.8 (0.9) v
8.4 (1.2) ng/ml, 2 mg v placebo,
p < 0.001). There was a similar trend with the 1 mg dose but the
changes were less noticeable.
ConclusionsHormone
replacement treatment with 17-oestradiol for nine
weeks significantly increased fibrinolytic potential in postmenopausal women with mild dyslipidaemia. This suggests that the cardioprotective effect of oestrogen may be mediated, in part, by an increase in fibrinolytic potential.
© 1998 by Heart
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