Cardiovascular Diseases Clinical Trial
To determine if postmenopausal hormone replacement therapy in women following coronary bypass surgery would reduce the occurrence of graft occlusion and delay the development of graft atherosclerosis.
BACKGROUND:
Coronary atherosclerosis is a major cause of death in women in the United States. Although
coronary artery bypass surgery decreases symptomatic and clinical evidence of ischemia, it
does not alter the underlying process. Patients may present several years later with
recurrent symptoms that may be a result of occlusion of saphenous vein grafts, development
of atherosclerotic disease in vein grafts, or progression of underlying disease. Any
intervention that can reduce the rate of progression of coronary atherosclerosis following
bypass surgery would provide significant benefit for women following bypass surgery and
possibly for other women with atherosclerotic disease. Observational studies suggest that
postmenopausal estrogen replacement therapy is associated with a reduction in cardiac
morbidity.
DESIGN NARRATIVE:
The study was a randomized, double-blind, controlled trial. Subjects were randomized to
conjugated estrogen with daily medroxyprogesterone or placebo within two weeks of bypass
surgery. Graft occlusion and development of vein graft atherosclerosis were measured by
comparing quantitative coronary angiographic and vascular ultrasonic assessment of disease
severity and extent performed at six months and three and a half years after randomization.
The primary outcome variables included the occurrence of graft occlusion at six months and
the change in severity and extent of atherosclerosis in the saphenous vein grafts over three
years. The trial determined the influence of hormone replacement therapy on the primary
outcome variables.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
;
Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Prevention
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