{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:56:29Z","timestamp":1760122589033},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP\u2010123588"],"award-info":[{"award-number":["MOP\u2010123588"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the rate of arterial thromboembolism (<jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content>) of drospirenone\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s to that of levonorgestrel\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United Kingdom's Clinical Practice Research Datalink (<jats:styled-content style=\"fixed-case\">CPRD<\/jats:styled-content>), which contains clinical records for &gt;11 million patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women aged 16\u201345 years prescribed a drospirenone\u2010 or levonorgestrel\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> between May 2002 and June 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted nested case\u2010control analyses using risk set sampling to randomly select up to 10 controls for each <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content> case, matched on age, cohort entry year, <jats:styled-content style=\"fixed-case\">CPRD<\/jats:styled-content> registration year, <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> user type (first\u2010time ever, new, switcher, or prevalent users), duration of <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> use, duration of progestin\u2010only or implantable contraceptive use, pre\u2010cohort entry duration of drospirenone and levonorgestrel use, and duration of follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>We used conditional logistic regression to estimate hazard ratios and 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s), adjusted for high\u2010dimensional propensity scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our cohort included 339 743 women followed over a mean 4.4 years, during which 228 <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content> cases occurred: 37 myocardial infarctions, 170 strokes, and 21 other <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content>s; overall rate: 1.5 events per 10 000 person\u2010years (<jats:styled-content style=\"fixed-case\">PY<\/jats:styled-content>s). After adjusting for potential confounders, the hazard ratio for <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content> with current use of drospirenone\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s versus current use of levonorgestrel\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s was 0.89 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.35, 2.28), corresponding to a rate difference of \u22120.16 events per 10 000 <jats:styled-content style=\"fixed-case\">PY<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The overall rate of <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content> in this population is low regardless of which <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> was taken. We found little evidence of a difference in the rate of <jats:styled-content style=\"fixed-case\">ATE<\/jats:styled-content> with drospirenone\u2010 versus levonorgestrel\u2010containing <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Little evidence was found of a greater incidence of arterial thrombosis with drospirenone versus levonorgestrel contraceptives.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14358","type":"journal-article","created":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T18:30:16Z","timestamp":1476297016000},"page":"1672-1679","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Drospirenone\u2010containing combined oral contraceptives and the risk of arterial thrombosis: a population\u2010based nested case\u2010control study"],"prefix":"10.1111","volume":"124","author":[{"given":"N","family":"Lariv\u00e9e","sequence":"first","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Suissa","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada"},{"name":"Division of Clinical Epidemiology Department of Medicine McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Eberg","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada"},{"name":"Division of Clinical Epidemiology McGill University Health Centre Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Eisenberg","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada"},{"name":"Division of Cardiology Jewish General Hospital McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HA","family":"Abenhaim","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"},{"name":"Department of Obstetrics and Gynecology Jewish General Hospital McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KB","family":"Filion","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Lady Davis Institute Jewish General Hospital Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada"},{"name":"Division of Clinical Epidemiology Department of Medicine McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,5]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"120","article-title":"Risk factors for venous and arterial thrombosis","volume":"9","author":"Previtali E","year":"2011","journal-title":"Blood Transfus"},{"key":"e_1_2_6_3_1","volume-title":"FDA Drug Safety Communication: Updated Information About the FDA\u2010Funded Study on Risk of Blood Clots in Women Taking Birth Control Pills Containing Dorspirenone","author":"Food and Drug Administration","year":"2011"},{"key":"e_1_2_6_4_1","volume-title":"Benefits of Combined Hormonal Contraceptives (CHCs) Continue to Outweigh Risks","author":"European Medicines Agency","year":"2013"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa003216"},{"key":"e_1_2_6_6_1","first-page":"CD011054","article-title":"Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke","author":"Roach REJ","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000015345.61324.3F"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.01.012"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03537.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp10X483562"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d2139"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2190-9"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098614548857"},{"key":"e_1_2_6_15_1","volume-title":"Centers for Disease Control and Prevention","author":"CDC","year":"2010"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.09.76"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.11.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.06.042"},{"key":"e_1_2_6_19_1","volume-title":"Epidemiology: Beyond the Basics","author":"Szklo M","year":"1999"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181a663cc"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000221"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/20786204.2005.10873166"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1783\/147118910793048665"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S6864"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.110463"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2014.01.023"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1111840"},{"key":"e_1_2_6_28_1","unstructured":"FDA Drug Safety Communication: Safety review update of Chantix (varenicline) and risk of cardiovascular adverse events 2012[www.fda.gov\/Drugs\/DrugSafety\/ucm330367.htm]. Accessed 7 October 2015."},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.09.015"},{"key":"e_1_2_6_30_1","volume-title":"Combined Hormonal Contraceptives (CHCs) and the Risk of Cardiovascular Disease Endpoints","author":"Food and Drug Administration Office of Surveillance and Epidemiology","year":"2011"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14358","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14358","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.14358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T02:07:17Z","timestamp":1694311637000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.14358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,5]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1111\/1471-0528.14358"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.14358","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,5]]},"assertion":[{"value":"2016-08-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}