Abstract

Association between Combined Hormonal Contraception Use and Deep Vein Thrombosis in Dyslipidemic Patients

Background: The risk of Deep Vein Thrombosis (DVT) and Combined Hormonal Contraception (CHC) use is well established in the literature in women of childbearing age. CHC has an estrogen component with a pro-thrombotic effect and progestin which can alter the lipid profile. There is controversy regarding the safety of CHC use in patients with dyslipidemia in terms of DVT. Thus, the association between CHC use and DVT risk in women with dyslipidemia needs to be reviewed. Objectives: This study aimed to assess the risk of DVT in women with dyslipidemia who were exposed to combined hormonal contraception compared to non-exposed women; to identify which CHC type carries the most DVT risk and to determine the association between CHC and lipid profile. Methods: Using a matched casecontrol study, we screened all women aged 18-79 years diagnosed with DVT in King Khalid University Hospital between 2017 and 2019 and abnormalities in their lipid profiles. We recruited 70 DVT cases and 210 controls from the family medicine outpatient clinic. Cases were matched to controls for age group, and all participants had dyslipidemia. The main outcome is a deep vein thrombosis event. Result: Combined hormone contraception use among dyslipidemic patients was significantly associated with a more than two-fold (OR=2.591, p<0.011, 95% CI: 1.244-5.396) increase in the risk of DVT. Conclusion: A theoretical concern is present for the use of CHCs in women with known dyslipidemia, and further studies are essential to confirm these findings.

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