Effect of Estrogen Plus Progestin on Progression of Carotid Atherosclerosis in Postmenopausal Women With Heart Disease
Key result
Estrogen plus progestin fails to slow carotid IMT progression vs placebo in postmenopausal women.
- P=0.44
- n=362
Why the study?
The effect of estrogen plus progestin on the progression of carotid atherosclerosis in postmenopausal women with established coronary disease was uncertain.
Does estrogen plus progestin reduce the progression of carotid atherosclerosis in postmenopausal women with established coronary disease?
Population
362 postmenopausal women with established coronary disease in the HERS trial
Comparison
Estrogen plus progestin vs placebo
Design
Randomized controlled trial substudy with carotid ultrasound
Follow-up
Mean 4.1 years
Authors
Discussion
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Implication
Does not support estrogen plus progestin for slowing carotid atherosclerosis in women with heart disease; reinforces guidelines against its use for cardiovascular prevention.
Study Design
Type
RCT (n=362)
Structured PICO
Does estrogen plus progestin reduce the progression of carotid atherosclerosis in postmenopausal women with established coronary disease?
P
Population
362 postmenopausal women with established coronary disease who underwent carotid ultrasound at baseline and end of follow-up (mean 4.1 years).
I
Intervention
Estrogen plus progestin
C
Comparator
Placebo
O
Outcome
Progression of carotid atherosclerosis measured as the temporal change in intimal-medial thickness (IMT)surrogate
Main Result
Absolute Event Rate: 26% vs 31%
p-value: p=0.44
Estrogen plus progestin does not slow the progression of carotid atherosclerosis in postmenopausal women with established coronary disease, supporting recommendations against its use for cardiovascular benefit.
Cite This Study
Byington et al. (2002) conducted an RCT in Postmenopausal women with established coronary disease (n=362). Estrogen plus progestin vs. Placebo was evaluated on Progression of carotid atherosclerosis (temporal change in intimal-medial thickness) (p=0.44). Estrogen plus progestin did not significantly affect the progression of carotid intimal-medial thickness compared with placebo in postmenopausal women with heart disease (26 vs 31 microm/y; P=0.44).