Evidence-Based Use of Different Types of Oral Contraceptive Pills and the Risk of Cardiovascular Diseases

• Activity Number: 188
• Type: Contributed
• Date/Time: Monday, August 4, 2014 : 10:30 AM to 12:20 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Shun Zhang*+ and Rust George and Djana Harp and Hedwige Saint-Louis
• Companies: National Center for Primary Care and National Center for Primary Care and Morehouse School of Medicine and Morehouse School of Medicine
• Keywords: evidence based medicine ; post marketing analysis ; contraception ; cardiovascular disease

Abstract

Objective: Contraceptive use is associated with an increased risk of venous thromboembolism and cardiovascular disease. There is no clinical evidence demonstrating increased efficacy of one type of contraceptive pill over another. Large claims data sets allow for post-marketing surveillance of low-rate, high-impact adverse effects of commonly used medications. This study assesses the risks of thromboembolism and cardiovascular disease associated with different types of progestins contained in oral contraceptive pills. Study Design: A retrospective study using a historical cohort from Medicaid claims data was designed to detect risk of acute myocardial infarction and thromboembolism related to different types of progestins in oral contraceptive pills. Results: A total of 142,236 women were included in the cohort. 10 cases of acute myocardial infarction (0.7 per 10,000 women per year), 45 venous thromboembolism events (3.2 per 10,000 women per year), and 38 deep vein thromboses (2.7 per 10,000 women per year) occurred in our study population. After adjusting for age, race, continuous oral contraceptive prescription, hypertension, diabetes, hypercholesterolemia history and other c