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13.
Acute myocardial infarction and combined oral contraceptives : results of an international multicentre case-control study
Debert-Ribeiro, Myriam ...
Background. The association between oral contraceptive (OC) use and acute myocardial infarction (AMI) was established in studies from northern Europe and the USA, which took place during the 1960s ...and 1970s. Few data are available to quantify the risk worldwide of AMI associated with use of OCs introduced since those early studies. This hospital-based case-control study examined the association between a first AMI and current OC use in women from Africa, Asia, Europe, and Latin America (21 centres). Methods. Cases were women aged 20-44 years who had definite or possible AMI (classified by history, electrocardiographic, and cardiac-enzyme criteria), who were admitted to hospital, and who survived for at least 24 h. Up to three hospitalcontrols matched by 5-year ageband were recruited for each of the 368 cases (941 controls). All participants were interviewed whilein hospital with the same questionnaire, which included information onmedical and personal history, lifetime contraceptive use, and blood-pressure screening before the most recent episode of OC use. Odds ratios compared the risk of AMI in current OC users and in non-users (past users and never-users combined). Findings. The overall odds ratio for AMI was 5.01 (95% CI 2.54-9.90) in Europe and 4.78 (2.52-9.07) in the nonEuropean (developing) countries; however, these risk estimates reflect the frequent coexistence of other risk factors among OC users who have AMI. Very few AMls were identified among women who had no cardiovascular risk factors and who reported that their blood pressure had been checked before OC use; odds ratiosassociated with (Abstract truncated at 2000 characters).
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