Heart fat and carotid artery atherosclerosis progression in recently menopausal women: impact of menopausal hormone therapy: The KEEPS trial.
Menopause
; 27(3): 255-262, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-32015261
OBJECTIVE: Heart fat deposition has been linked to atherosclerosis, and both accelerate after menopause. Hormone therapy (HT) may differentially slow heart fat deposition and progression of atherosclerosis, depending on the specific HT agent or its route of administration. Our objective was to evaluate the effects of different HT agents, oral and transdermal, on associations between heart fat accumulation and atherosclerosis progression, measured by carotid intima-media thickness (CIMT), in recently menopausal women from the Kronos Early Estrogen Prevention Study (KEEPS) trial. METHODS: KEEPS was a randomized, placebo-controlled trial of the effects of 0.45âmg/d oral conjugated equine estrogens (o-CEE) or 50âmcg/d transdermal 17ß-estradiol (t-E2), compared with placebo, on 48 months progression of CIMT. Epicardial adipose tissue (EAT) and paracardial adipose tissue (PAT) volumes were quantified by computed tomography. RESULTS: In all, 467 women (mean age [SD] 52.7 [2.5]; 78.2% White; 30% on o-CEE, 30.8% t-E2, 39.2% placebo) with heart fat volumes and CIMT at baseline and 48 months were included. EAT and PAT changes were not associated with CIMT progression; however, the assigned treatment significantly modified the association between PAT (but not EAT) change and CIMT progression. In the o-CEE group, adjusted CIMT progression was 12.66âµm (95% confidence interval [CI] 1.80, 23.52) lower than in t-E2 group (Pâ=â0.02), and 10.09âµm (95% CI 0.79, 19.39) lower than in placebo group (Pâ=â0.03), as per 1-SD increase in PAT. CONCLUSION: Compared with t-E2, o-CEE appears to slow down the adverse effect of increasing PAT on progression of atherosclerosis. Whether this beneficial association is specific to CEE or to the oral route of CEE administration is unclear and should be assessed further.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças das Artérias Carótidas
/
Terapia de Reposição de Estrogênios
/
Estrogênios Conjugados (USP)
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Estradiol
/
Aterosclerose
/
Estrogênios
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Menopause
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de publicação:
Estados Unidos