Do combined oral contraceptives increase the risk of myocardial infarction or ischemic stroke in women?
Combined oral contraceptives are associated with a 1.6-fold increased risk of myocardial infarction or ischemic stroke, with formulations containing levonorgestrel and 30 μg of estrogen appearing to be the safest.
This meta-analysis showed that the risk of myocardial infarction or ischemic stroke was 1.6-fold increased in women using COCs . The risk was highest for pills with > 50 microgram estrogen. When combined with the results of studies on the risk of venous thrombosis in COC users, it seems that the COC pill containing levonorgestrel and 30 μg of estrogen is the safest oral form of hormonal contraception.
Roach et al. (Thu,) studied this question.