116 Lipoprotein(a) [Lp(a)]levels and isoforms and fibrinolytic activity in postmenopause. Influence of hormone replacement therapy (HRT)

SummaryEpidemiological studies suggest that hormone replacement therapy (HRT) decreases the risk of cardiovascular disease in postmenopausal women via several mechanisms, including modifications in the fibrinolytic system and lipoprotein(a) [Lp(a)] levels. The aim of this study was to examine the influence of the levels and isoforms of Lp(a) on fibrinolytic activity in 91 postmenopausal women in comparison with premenopause and analyze the effect of HRT on those parameters. In postmenopause, an increase in plasma Lp(a) and plasminogen activator inhibitor-1 (PAI-1) levels was found. A significant inverse correlation was observed between Lp(a) or PAI-1 levels and plasmin generation. Plasma samples with low molecular weight (MW) apo(a) isoforms showed higher plasmin inhibition than plasmas with high MW apo(a) isoforms and similar levels of total Lp(a) and PAI-1. HRT induced a significant decrease in Lp(a) and PAI-1 levels and an increase in estradiol levels, as well as an increase in fibrinolytic activity. A significant correlation was found between the percentages of variation in Lp(a) levels and in plasmin generation and between the percentages of variation in PAI-1 levels and in the euglobulin lysis time under HRT. In conclusion, the increase in fibrinolytic activity observed in women under HRT could be explained by two independent mechanisms: (a) the decrease in PAI-1 and (b) the decrease in the inhibition of plasmin generation due to the decrease in Lp(a) levels.

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The effect of hormone replacement therapy and tibolone on lipoprotein (a) concentrations in postmenopausal women: a systematic review and meta-analysis of randomized controlled studies

Endocrine Abstracts ◽

10.1530/endoabs.49.ep1084 ◽

2017 ◽

Author(s):

Panagiotis Anagnostis ◽

Petros Galanis ◽

Vasileia Chatzistergiou ◽

John Stevenson ◽

Ian Godsland ◽

...

Keyword(s):

Systematic Review ◽

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Postmenopausal Women ◽

Meta Analysis ◽

Hormone Replacement ◽

Lipoprotein A ◽

Randomized Controlled ◽

Randomized Controlled Studies

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Effects of Hormone Replacement Therapy on Plasma and Tissue Fibrinolytic Activity in a Rat Model of Surgically Induced Menopause

Clinical & Investigative Medicine ◽

10.25011/cim.v37i2.21090 ◽

2014 ◽

Vol 37 (2) ◽

pp. 85 ◽

Cited By ~ 1

Author(s):

Ata Topcuoglu ◽

Mustafa Albayrak ◽

Hayriye Erman ◽

Huriye Balci ◽

Mesut Karakus ◽

...

Keyword(s):

Hormone Replacement Therapy ◽

Oral Administration ◽

Replacement Therapy ◽

Plasminogen Activator ◽

Brain Tissue ◽

Fibrinolytic Activity ◽

Hormone Replacement ◽

17Β Estradiol ◽

Surgically Induced ◽

Pai 1

Purpose: The purpose of this study was to analyze the effects of estrogen deficiency and hormone replacement therapy (HRT) on fibrinolytic activity in a rat mode of surgically-induced menopause. Methods: Twelve-week-old, sexually mature female Sprague-Dawley rats, each weighing 200–250 g, were randomly divided into four groups: (1) sham-operated group, (2) ovariectomy group, (3) ovariectomy group followed by oral administration of daily 17β-estradiol (0.02 mg/kg/day) (E2) + norethisterone acetate (0.01 mg/kg/day), and (4) ovariectomy group followed by oral administration of daily 17β-estradiol (0.01 mg/kg/day) + drospirenone (0.02 mg/kg/day). Tissue plasminogen activator (tPA) antigen, plasminogen activator inhibitor-1 (PAI-1) antigen, and PAI-1/tPA levels were measured as markers of fibrinolysis in plasma and liver and brain tissue. Results: Compared with sham-operated rats, ovariectomized rats showed higher levels of fibrinolytic activity; however, the increased fibrinolytic activity in plasma and liver tissue was significantly reduced by HRT regimens. No change was observed in the levels of fibrinolytic activity in brain tissue. Conclusions: HRT showed beneficial effects by decreasing fibrinolytic activity related to surgically-induced menopause. Short-term HRT treatment was associated with a shift in the procoagulant-anticoagulant balance toward a procoagulant state.

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