Changes in haemostatic parameters induced by drospirenone-containing oral contraceptives

• Published in: Geburtshilfe und Frauenheilkunde
• Main Authors: Tchaikovski, SN, Thomassen, MCLGD, Costa, SD, Brandkvist, C, Bremme, K, Rosing, J
• Format: Conference Proceeding
• Language: English
• Published: 30.08.2011
• ISSN: 0016-5751; 1438-8804
• DOI: 10.1055/s-0031-1286406

Introduction: Oral contraceptives (OC) increase the risk of venous thrombosis. The thrombosis risk is dependent on the OC formulation and may be explained by an increased endogenous thrombin potential and acquired resistance to activated protein C (APC). There is limited information on the effect of OC, containing one of the newest progestogen-compounds drospirenone (DRSP-OC) on the endogenous thrombin potential and APC resistance. Methods: In a study population consisting of 14 healthy women between 21 and 33 years of age we investigated the effect of DRSP-OC on thrombin generation, APC resistance, the function of the TFPI system and on the plasma concentrations of protein C, total and free protein S, full length and free TFPI, prothrombin, antithrombin, factor (F) V, FX, FVIII. Results: After 2 months of DRSP-OC use a significant increase in thrombin generation at low and high tissue factor concentrations (115% and 37% respectively), APC resistance (136%) and plasma concentrations of prothrombin (18%), FX (32%), FVIII (18%) and protein C (42%) was observed. DRSP-OC considerably decreased the function of the TFPI system, as well as the plasma levels of full length and free TFPI (-36% and -44% respectively), total and free protein S (-20% and -20% respectively), FV (-22%) and antithrombin (-6%). Conclusions: DRSP-OC induce multiple changes in the plasma concentrations of coagulation factors and anticoagulant proteins, which lead to a substantial increase of thrombin generation and more than double APC resistance. We further demonstrated a considerable impairment of the function of the TFPI system during DRSP-OC use.