Elevated Plasma Fibrinogen and Increased Fibrin Turnover among Healthy Women who both Smoke and Use Low-dose Oral Contraceptives

Pierre-Yves Scarabin; Anne-Marie Vissac; Jean-Michel Kirzin; Pierre Bourgeat; Jean Amiral; Rachid Agher; Louis Guize

doi:10.1055/s-0037-1614338

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 82(03): 1112-1116
DOI: 10.1055/s-0037-1614338

Letters to the Editor

Schattauer GmbH

Elevated Plasma Fibrinogen and Increased Fibrin Turnover among Healthy Women who both Smoke and Use Low-dose Oral Contraceptives

A Preliminary Report

Pierre-Yves Scarabin

³From INSERM, Cardiovascular Epidemiology Unit, U258, Hôpital Paul Brousse, Villejuif, France

,

Anne-Marie Vissac

¹Laboratoire Serbio, Gennevilliers, France

,

Jean-Michel Kirzin

²Centre d’Investigations Préventives et Cliniques (IPC), Paris, France

,

Pierre Bourgeat

¹Laboratoire Serbio, Gennevilliers, France

,

Jean Amiral

¹Laboratoire Serbio, Gennevilliers, France

,

Rachid Agher

³From INSERM, Cardiovascular Epidemiology Unit, U258, Hôpital Paul Brousse, Villejuif, France

,

Louis Guize

²Centre d’Investigations Préventives et Cliniques (IPC), Paris, France

› Author Affiliations

Abstract

Summary

Among users of low-dose oral contraceptives (OC), cardiovascular diseases occur mainly in smokers. The mechanisms by which OC and smoking increase the risk for arterial thrombotic risk have not been adequately explained. Epidemiological evidence suggests that changes in blood coagulation and fibrinolysis may play an important role as determinants of thrombotic events. Therefore, we have investigated the associations of OC and smoking with haemostatic variables among 194 premenopausal healthy women. Fourty women were current users of low-dose OC and 62 women were smokers. After adjustment for age and body mass index, mean values of factor XIIa, factor VII activity and antigen, fibrinogen, D-dimer, global fibrinolytic capacity were significantly higher in OC users than in non-users. Mean levels of PAI activity and t-PA antigen were significantly lower in OC users than in non-users. Smokers had significantly higher mean values of fibrinogen than non-smokers. Two-way analysis of variance showed that the differences in mean levels of fibrinogen and D-dimer between OC users and non users were restricted to smokers. The positive and significant interactions between OC use and smoking in their effects on haemostatic variables were consistent with respect to age and type of OC. These preliminary data suggest that elevated plasma levels of fibrinogen and intravascular fibrin deposition may play a role in the pathogenesis of arterial thrombotic disease among women who are both low-dose OC users and smokers.

Full Text

References

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