Journal article
Effects of postmenopausal hormone therapy on incident atrial fibrillation: the Women's Health Initiative randomized controlled trials
Circulation. Arrhythmia and electrophysiology, Vol.5(6), pp.1108-1116
12/2012
DOI: 10.1161/CIRCEP.112.972224
PMID: 23169946
Abstract
Atrial fibrillation (AF) is less prevalent in women versus men, but associated with higher risks of stroke and death in women. The role hormone therapy plays in AF is not well understood.
The Women's Health Initiative randomized postmenopausal women to placebo or conjugated equine estrogens (0.625 mg/d) plus medroxyprogesterone acetate (2.5 mg/d) if they had a uterus (N=16 608) or to conjugated equine estrogens only if they had prior hysterectomy (N=10 739). Incident AF was identified by ECG and diagnosis codes from Medicare claims or hospitalization records. Hazard ratios for incident AF were estimated using Cox proportional hazards regression. After excluding participants with baseline AF, there were 611 incident AF cases over a mean of 5.6 years among 16 128 estrogen plus progestin participants, and 683 cases over a mean of 7.1 years among 10 251 conjugated equine estrogens alone participants. Incident AF was more frequent in the active groups of both trials, reaching statistical significance in the trial of conjugated equine estrogens alone in women with prior hysterectomy (hazard ratio, 1.17; CI, 1.00-1.36; P=0.045) and in the pooled analysis (hazard ratio, 1.12; CI, 1.00-1.24; P=0.05), but not in the estrogen plus progestin trial (hazard ratio, 1.07; CI, 0.91-1.25; P=0.44). These results were only minimally affected by adjustment for incident stroke, coronary heart disease, and heart failure.
Incident AF was modestly elevated in hysterectomized women randomized to postmenopausal E-alone, and in the pooled group randomized to E-alone or estrogen plus progestin. The trend in women with intact uterus receiving estrogen plus progestin, considered separately, was not statistically significant.
ClinicalTrials.gov; Identifier: NCT00000611.
Details
- Title: Subtitle
- Effects of postmenopausal hormone therapy on incident atrial fibrillation: the Women's Health Initiative randomized controlled trials
- Creators
- Marco V Perez - Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA. mvperez@stanford.eduPaul J WangJoseph C LarsonBeth A VirnigBarbara CochraneJ David CurbLiviu KleinJoAnn E MansonLisa W MartinJennifer RobinsonSylvia Wassertheil-SmollerMarcia L Stefanick
- Resource Type
- Journal article
- Publication Details
- Circulation. Arrhythmia and electrophysiology, Vol.5(6), pp.1108-1116
- Publisher
- United States
- DOI
- 10.1161/CIRCEP.112.972224
- PMID
- 23169946
- ISSN
- 1941-3149
- eISSN
- 1941-3084
- Grant note
- 42115 / PHS HHS 42109 / PHS HHS 32108 / PHS HHS 42111 / PHS HHS 42130 / PHS HHS 32101 / PHS HHS 42125 / PHS HHS 32105 / PHS HHS 42121 / PHS HHS 42118 / PHS HHS 42114 / PHS HHS 32113 / PHS HHS 32109 / PHS HHS 42110 / PHS HHS 32100 / PHS HHS 42124 / PHS HHS 42129 / PHS HHS 42119 / PHS HHS 32118 / PHS HHS 42120 / PHS HHS 42113 / PHS HHS 24152 / PHS HHS 32106 / PHS HHS 32112 / PHS HHS 42107 / PHS HHS 42123 / PHS HHS 32122 / PHS HHS 32119 / PHS HHS 42116 / PHS HHS 32115 / PHS HHS 44221 / PHS HHS 42112 / PHS HHS 42108 / PHS HHS 42131 / PHS HHS 32111 / PHS HHS 32102 / PHS HHS 42126 / PHS HHS N01WH22110 / WHI NIH HHS 42132 / PHS HHS 42122 / PHS HHS 42117 / PHS HHS
- Language
- English
- Date published
- 12/2012
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9983996195202771
Metrics
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