For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .
Fibrinolysis and lipoprotein(a) in women with coronary artery disease. Influence of hormone replacement therapy.
BACKGROUND AND OBJECTIVES The incidence of coronary artery disease ( CAD ) is higher in post-menopausal than in pre-menopausal women . Epidemiological studies suggest that hormone replacement therapy ( HRT ) decreases the risk of cardiovascular disease in post-menopausal women .  HRT could modify the cardiovascular risk via several mechanisms , including modifications in the fibrinolytic system and lipoprotein ( a ) levels . Our study was aim ed at investigating some of these modifications . DESIGN AND METHODS In the cross-sectional part of the study we evaluated several components of the fibrinolytic system , coagulation inhibitors and lipid profile in premenopausal ( n=15 ) and post-menopausal women ( n=64 ) with CAD and compared these parameters with those of healthy pre-menopausal ( n=31 ) and post-menopausal women ( n=88 ) . The prospect i ve part of the study analyzed the effect of HRT with transdermal estrogen with or without progestogen in post-menopausal women with CAD . RESULTS Pre- and postmenopausal women with CAD showed significant lower fibrinolytic activity and higher plasminogen activator inhibitor type 1 ( PAI-1 ) levels than their control groups . Lp(a ) levels were higher in premenopausal women with CAD than in healthy premenopausal women . In post-menopausal women with CAD , HRT induced a significant decrease in PAI-1 and Lp(a ) levels . No significant differences were observed in any parameter studied between the groups treated with transdermal estrogen with and without progestogen . INTERPRETATION AND CONCLUSIONS CAD is associated with a decrease in fibrinolytic activity , possibly due to an increase in PAI-1 levels . An increase in fibrinolytic activity and a decrease in PAI-1 and Lp(a ) levels were observed in CAD women receiving transdermal HRT and these changes may have a favorable impact on the risk of new cardiovascular events in post-menopausal CAD women
For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .