{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:16:07Z","timestamp":1788250567830,"version":"build-2803163510"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>\n            Background\u2003Polycystic ovarian syndrome (PCOS) affects up to 18% of reproductive-aged women with increased risks of cardiovascular disease and venous thromboembolic disease, related to metabolic and hormonal features, obesity and an apparent hypofibrinolytic state, possibly exacerbated by current PCOS treatments.<\/jats:p><jats:p>\n            Objective\u2003To investigate and compare haemostatic impacts of common pharmacological treatments and explore relationships with hormonal and metabolic variables in PCOS.<\/jats:p><jats:p>\n            Patients\/Methods\u2003This mechanistic sub-study using biobanked samples from a 6-month randomized comparative trial of pharmacological treatments assessed pro- and anti-thrombotic markers and overall haemostatic activity. Overweight women of mean age 33.9\u2009\u00b1\u20096.7 years and mean BMI (body mass index) of 36.5\u2009\u00b1\u20097.0 kg\/m2 with PCOS (n\u2009=\u200960) were randomized to either metformin, higher-dose oral contraceptive pill (OCP) or low-dose OCP\u2009+\u2009spironolactone (OCP\u2009+\u2009S). Primary outcome measures included changes in plasminogen activator inhibitor 1 (PAI-1), asymmetric dimethylarginine (ADMA), prothrombin fragments 1 and 2 (PF1 and 2), plasminogen, tissue plasminogen activator (tPA), thrombin activatable fibrinolysis inhibitor (TAFI) and thrombin generation (TG).<\/jats:p><jats:p>\n            Results\u2003PAI-1 activity fell in all groups, ADMA fell in higher-dose OCP, PF1 and 2 increased with metformin and higher-dose OCP, TG rose and tPA fell in both OCP groups, plasminogen increased in all and TAFI increased after higher-dose OCP.<\/jats:p><jats:p>\n            Conclusion\u2003Endothelial function (primary haemostasis) improved with higher dose with some improvement in low-dose OCP\u2009+\u2009S and metformin. Aberrant coagulation was noted in both OCP groups, but not with metformin. Fibrinolysis was reduced with higher-dose OCP. Our work suggests an additional dimension of treatment (haemostatic system effects) that favours metformin treatment over the OCP in PCOS.<\/jats:p>","DOI":"10.1160\/th17-04-0248","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T06:56:29Z","timestamp":1513752989000},"page":"2053-2062","source":"Crossref","is-referenced-by-count":8,"title":["Differential Effects on Haemostatic Markers by Metformin and the Contraceptive Pill: A Randomized Comparative Trial in PCOS"],"prefix":"10.1160","volume":"117","author":[{"given":"Genia","family":"Burchall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence","family":"Piva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeeva","family":"Ranasinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Teede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,11,30]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1160\/TH17-04-0248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T19:38:52Z","timestamp":1557171532000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1160\/TH17-04-0248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2017,11,30]]},"published-print":{"date-parts":[[2017,11]]}},"URL":"https:\/\/doi.org\/10.1160\/th17-04-0248","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017]]}}}