Venous thromboembolism in women using hormonal contraceptives

Ángeles Blanco-Molina; Javier Trujillo-Santos; Raimundo Tirado; Inmaculada Cañas; Antoni Riera; Mariano Valdés; Manuel Monreal; for the RIETE Investigators

doi:10.1160/TH08-10-0684

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2009; 101(03): 478-482
DOI: 10.1160/TH08-10-0684

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Venous thromboembolism in women using hormonal contraceptives

Findings from the RIETE Registry

Ángeles Blanco-Molina

¹Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain

,

Javier Trujillo-Santos

²Department of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia, Spain

,

Raimundo Tirado

³Department of Internal Medicine, Hospital Infanta Margarita, Cabra, Córdoba, Spain

,

Inmaculada Cañas

⁴Department of Internal Medicine, Hospital General de Granollers, Granollers, Barcelona, Spain

,

Antoni Riera

⁵Department of Internal Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

,

Mariano Valdés

⁶Department of Internal Medicine, Hospital de Viladecans, Viladecans, Barcelona, Spain

,

Manuel Monreal

⁷Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

,

for the RIETE Investigators

› Institutsangaben

Abstract

Summary

There is scarce information on the clinical characteristics of contraceptive users who develop venous thromboembolism (VTE). RIETE is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We analyzed the clinical characteristics and additional risk factors for VTE in all enrolled women aged <50 years who were using or not using contraceptives at presentation with VTE. Of 1,667 women aged <50 years enrolled in RIETE as of December 2007, 593 (36%) were contraceptive users. Of 270 aged <25 years, 190 (70%) were users. Ninety-two contraceptive users (16%) had over-weight, 89 (15%) were obese. Of 951 women with no additional risk factors for VTE (i.e. recent surgery, immobility or cancer) 457 (48%) were contraceptive users. Eighty-seven (15%) users had recent immobility for ≥4 days, 44 (7.4%) were postoperative. The most common reason for immobility was lower limb trauma not requiring surgery; 25% of users with recent immobility had received thromboprophylaxis. The most common type of surgery was non-major orthopaedic surgery. Twenty-one (48%) users with postoperative VTE had received prophylaxis. The percentage of users and non-users who tested positive for thrombophilia was similar. Contraceptive use remains the most frequent risk factor for VTE in women at fertile age. Identifying those at increased risk for VTE seems to be difficult. In the meanwhile, a higher use of thromboprophylaxis during immobility or minor surgery should be warranted.

Keywords

Contraceptives - venous thromboembolism - prevention

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Referenzen

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