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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Comparative Study of the Effects of Combined Oral Contraceptives in Hemostatic Variables An Observational Preliminary Study

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Autor(es):
Stocco, Bianca ; Fumagalli, Helen F. ; Franceschini, Silvio A. [1] ; Martinez, Edson Z. [2] ; Marzocchi-Machado, Cleni M. [1] ; Felipe, Marcos ; Toloi, Maria Regina T. [1]
Número total de Autores: 7
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Gynecol & Obstet, BR-14049 Ribeirao Preto - Brazil
[2] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Social Med, BR-14049 Ribeirao Preto - Brazil
Número total de Afiliações: 2
Tipo de documento: Artigo Científico
Fonte: MEDICINE; v. 94, n. 4 JAN 2015.
Citações Web of Science: 11
Resumo

Thrombotic risk is associated with the estrogen dose and type of progestin in combined oral contraceptives. Studies published since 1990 showed that third-generation progestins have larger risk to contribute to thrombosis development than the second-generation. However, there are conflicts in the literature regarding the thrombotic risk associated to the drospirenone progestin. So, this study aimed to evaluate the effects of 3 formulations of contraceptives containing ethinylestradiol (EE) (20 and 30 mu g) combined with drospirenone versus levonorgestrel combined with EE (30 mu g) in hemostatic parameters. This cross-sectional study included 70 healthy women between 18 and 30 years, BMI 19 to 30 kg/m(2), not pregnant, non-smokers, and users or non-users (control) of contraceptives for a minimum period of 6 months. The following parameters were assessed: prothrombin time (PT), Factor VII, activated partial thromboplastin time (aPTT), Factor XII, fibrinogen, Factor 1 + 2, Protein C, Protein S, antithrombin, D-dimers, and plasminogen activator inhibitor-1. Significant alterations were found in PT, aPTT, fibrinogen, D-dimers, and protein S, all favoring a state of hypercoagulation for contraceptive containing DRSP/20EE. Both contraceptives containing DRSP/30EE and LNG/30EE promoted changes that favor the hyper-coagulability in the coagulant variable PT and in the anticoagulant variables Protein S and Protein C, respectively. We suggest that the progestin drospirenone can contribute to an inadequate balance among procoagulant, anticoagulant, and fibrinolytic factors, since that the contraceptive containing the lowest dose of estrogen and drospirenone (DRSP/20EE) caused a higher number of hemostatic changes. (AU)

Processo FAPESP: 07/58578-7 - Avaliação do efeito de contraceptivos hormonais sobre o sistema complemento e a hemostasia
Beneficiário:Maria Regina Torqueti
Modalidade de apoio: Auxílio à Pesquisa - Regular