Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol

Abstract This study aimed to evaluate the risk of ischemic stroke (IS) in hormone therapy (HT) with oral conjugated equine estrogen (CEE) and estradiol (E2) in postmenopausal women in Taiwan. A retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database, a p...

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Autores principales:	Wei-Chuan Chang, Jen-Hung Wang, Dah-Ching Ding
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ba65fd413434417cb016abf01f08152d
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spelling	oai:doaj.org-article:ba65fd413434417cb016abf01f08152d2021-12-02T14:49:24ZConjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol10.1038/s41598-021-90357-62045-2322https://doaj.org/article/ba65fd413434417cb016abf01f08152d2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90357-6https://doaj.org/toc/2045-2322Abstract This study aimed to evaluate the risk of ischemic stroke (IS) in hormone therapy (HT) with oral conjugated equine estrogen (CEE) and estradiol (E2) in postmenopausal women in Taiwan. A retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database, a population-based healthcare claims dataset. Eligible women, aged 40–65 years, who received HT with E2 and CEE orally were enrolled. The primary outcome was IS. Propensity score matching with menopausal age and comorbidities was used. Cox proportional hazard regression models were used to calculate the incidence and hazard ratios (HRs) for IS. The mean menopausal ages of the E2 and CEE groups were 50.31 ± 4.99 and 50.45 ± 5.31 years, respectively. After adjusting for age and comorbidities, the incidence of IS was 1.17-fold higher in the women treated with CEE than in those treated with E2 (4.24 vs. 3.61/1000 person-years), with an adjusted HR (aHR) of 1.23 (95% confidence interval [CI] 1.05–1.44). Moreover, HT with CEE initiated within 5 years of menopause had a higher HR than E2 (aHR = 1.20; 95% CI 1.02–1.42). In conclusion, HT with oral CEE might be associated with a higher risk of IS than E2 in postmenopausal Taiwanese women. The use of HT with CEE should be cautioned with the risk of IS.Wei-Chuan ChangJen-Hung WangDah-Ching DingNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wei-Chuan Chang Jen-Hung Wang Dah-Ching Ding Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
description	Abstract This study aimed to evaluate the risk of ischemic stroke (IS) in hormone therapy (HT) with oral conjugated equine estrogen (CEE) and estradiol (E2) in postmenopausal women in Taiwan. A retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database, a population-based healthcare claims dataset. Eligible women, aged 40–65 years, who received HT with E2 and CEE orally were enrolled. The primary outcome was IS. Propensity score matching with menopausal age and comorbidities was used. Cox proportional hazard regression models were used to calculate the incidence and hazard ratios (HRs) for IS. The mean menopausal ages of the E2 and CEE groups were 50.31 ± 4.99 and 50.45 ± 5.31 years, respectively. After adjusting for age and comorbidities, the incidence of IS was 1.17-fold higher in the women treated with CEE than in those treated with E2 (4.24 vs. 3.61/1000 person-years), with an adjusted HR (aHR) of 1.23 (95% confidence interval [CI] 1.05–1.44). Moreover, HT with CEE initiated within 5 years of menopause had a higher HR than E2 (aHR = 1.20; 95% CI 1.02–1.42). In conclusion, HT with oral CEE might be associated with a higher risk of IS than E2 in postmenopausal Taiwanese women. The use of HT with CEE should be cautioned with the risk of IS.
format	article
author	Wei-Chuan Chang Jen-Hung Wang Dah-Ching Ding
author_facet	Wei-Chuan Chang Jen-Hung Wang Dah-Ching Ding
author_sort	Wei-Chuan Chang
title	Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
title_short	Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
title_full	Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
title_fullStr	Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
title_full_unstemmed	Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
title_sort	conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ba65fd413434417cb016abf01f08152d
work_keys_str_mv	AT weichuanchang conjugatedequineestrogenusedinpostmenopausalwomenassociatedwithahigherriskofstrokethanestradiol AT jenhungwang conjugatedequineestrogenusedinpostmenopausalwomenassociatedwithahigherriskofstrokethanestradiol AT dahchingding conjugatedequineestrogenusedinpostmenopausalwomenassociatedwithahigherriskofstrokethanestradiol
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Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol

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