Key result
Oral conjugated equine estrogens reduced the likelihood of any increase in epicardial adipose tissue compared with placebo in recently menopausal women (OR 0.62; 95% CI 0.40-0.97; P=0.03).
Why the study?
Heart fats are greater after menopause and may be regulated by endogenous estrogen, but the differential effects of hormone therapy formulations on heart fat accumulation and CAC progression were unknown.
Does hormone therapy (oral conjugated equine estrogens or transdermal 17β-estradiol) affect heart fat accumulation and CAC progression in early menopausal women?
Population
474 recently menopausal women from KEEPS with baseline and 48-month CT measures
Comparison
Oral conjugated equine estrogens vs transdermal 17β-estradiol vs placebo
Design
Multicenter randomized placebo-controlled trial secondary analysis
Follow-up
48 months
Authors
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May slow epicardial fat accumulation with oral estrogens in early menopause; extends RCT evidence on hormone therapy and cardiac adiposity.
RCT (n=474)
placebo-controlled
randomized
Yes
Does hormone therapy (oral conjugated equine estrogens or transdermal 17β-estradiol) affect heart fat accumulation and CAC progression in early menopausal women?
Odds Ratio: 0.62 (95% CI 0.4–0.97)
p-value: p=0.03
In early menopausal women, oral conjugated equine estrogens may slow epicardial adipose tissue accumulation, whereas transdermal 17β-estradiol may increase CAC progression associated with paracardial fat accumulation.
Khoudary et al. (2019) conducted an RCT in early menopause (n=474). oral conjugated equine estrogens and transdermal 17β-estradiol vs. placebo was evaluated on any increase in epicardial adipose tissue (OR 0.62, 95% CI 0.40-0.97, p=0.03). Oral conjugated equine estrogens reduced the likelihood of any increase in epicardial adipose tissue compared with placebo in recently menopausal women (OR 0.62; 95% CI 0.40-0.97; P=0.03).
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