Randomized trial of hormone therapy in women after coronary bypass surgery: Evidence of differential effect of hormone therapy on angiographic progression of disease in saphenous vein grafts and native coronary arteries

摘要: Clinical trials indicate that hormone therapy (HT) does not decrease cardiovascular disease events or angiographic coronary progression. The effects of HT on SVG vessels are unknown. To determine whether postmenopausal started after bypass surgery (CABG) decreases saphenous vein graft (SVG) disease, we conducted a multicenter randomized placebo-controlled study estradiol+/-medroxyprogesterone within 6 months CABG in 83 women. Angiographic and intravascular ultrasound (IVUS) assessment at 42 was planned to assess stopped early following publication the Women's Health Initiative Estrogen/Progestin study. Eighty-three subjects underwent 6-month angiogram with 63 undergoing IVUS. Forty-five completed 42-month (20 IVUS). In analysis paired 6- IVUS studies, slowed progression assessed by mean percent stenosis (p<0.001), minimal lumen diameter (p=0.029), total plaque volume (p=0.006). contrast, accelerated non-bypassed native arteries (minimum diameter, p=0.01). closure occurred 38% 1-year post-CABG. groups had similar frequency expect for angioplasty eight compared one placebo subject (p<0.05). indicated arterial stenoses while stenosis. This suggests treatment may slow accelerating atherosclerosis arteries.