What does this research mean for the field?

There is no significant association between the use of combined oral contraceptives, including both second and third-generation products, and the risk of myocardial infarction in young women. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the association between incident myocardial infarction and the use of different types of oral contraceptives among young women.

June 12, 1999BMJOpen Access

Oral contraceptives and myocardial infarction: results of the MICA case-control study Commentary: Oral contraceptives and myocardial infarction: reassuring new findings

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Why the study?

Does the use of combined oral contraceptives increase the risk of myocardial infarction in young women aged 16-44?

Key Points

To determine the association between incident myocardial infarction and the use of different types of oral contraceptives among young women.
Community-based case-control study conducted across England, Scotland, and Wales including 448 cases aged 16 to 44 with incident myocardial infarction between October 1993 and October 1995, and 1,728 age- and general practice-matched controls.
Information on exposure to combined oral contraceptives, specific progestagen types, and cardiovascular risk factors was gathered from patient interviews and general practice records.
Current use of combined oral contraceptives was not significantly associated with myocardial infarction (adjusted OR 1.40, 95% CI 0.78 to 2.52), with adjusted ORs of 1.10 (95% CI 0.52 to 2.30) for second-generation and 1.96 (95% CI 0.87 to 4.39) for third-generation formulations.
Direct comparison between third-generation and second-generation oral contraceptives showed no significant difference (adjusted OR 1.78, 95% CI 0.66 to 4.83), and no effect was observed for progestagen subtype or duration of use.
Cardiovascular risk factors or smoking were present in 88% of cases, with smoking ≥20 cigarettes daily demonstrating a strong independent association with myocardial infarction (adjusted OR 12.5, 95% CI 7.29 to 21.5).

Structured PICO

Does the use of combined oral contraceptives increase the risk of myocardial infarction in young women aged 16-44?

Population

2,176 women aged 16-44, comprising 448 cases with incident myocardial infarction and 1,728 controls matched for age and general practice.

Intervention

Current use of combined oral contraceptives (including second and third generation products).

Comparator

Non-users of oral contraceptives (and second generation users for the third generation comparison).

Outcome

Incident myocardial infarction.hard clinical

In young women, the use of combined oral contraceptives was not significantly associated with an increased risk of myocardial infarction, whereas smoking was a strong risk factor.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

No significant MI association seen with combined oral contraceptives; leaves open need for larger prospective studies on cardiovascular safety.

Cite This Study

Dunn et al. (1999) studied this question.

synapsesocial.com/papers/6a1a383731dddbe2d1afa679 https://doi.org/10.1136/bmj.318.7198.1579

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Implication

No significant MI association seen with combined oral contraceptives; leaves open need for larger prospective studies on cardiovascular safety.

Oral contraceptives and myocardial infarction: results of the MICA case-control study Commentary: Oral contraceptives and myocardial infarction: reassuring new findings

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Oral contraceptives and myocardial infarction: results of the MICA case-control study Commentary: Oral contraceptives and myocardial infarction: reassuring new findings

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider