CoChat
Sign Up
Cited by 98Venous Thromboembolism Diagnosis and ManagementBlood Coagulation and Thrombosis MechanismsMenopause: Health Impacts and Treatments

Short-term effects of estrogen, tamoxifen and raloxifene on hemostasis: a randomized-controlled study and review of the literature

Cosman, F., Baz-Hecht, M., Cushman, M., Vardy, M.D., Cruz, J.D., Nieves, J.W., Zion, M., Lindsay, R.·2005·Thrombosis Research
DOI 10.1016/j.thromres.2004.09.014
Open this paper in CoChat — free account

Abstract

Introduction Estrogen therapy (ET), tamoxifen and raloxifene are associated with a two- to three-fold increased risk of venous thrombosis (VT); however, the mechanisms by which each drug increases venous thrombosis propensity are not fully understood. The objectives of this investigation were to compare the effects of these three treatments on hemostasis in a head to head randomized placebo-controlled trial.Patients/methods Ninety-four postmenopausal women were assigned to receive oral estrogen (conjugated equine estrogen [CEE] 0.625 mg, n=23), tamoxifen 20 mg (n=24), raloxifene 60 mg (n=24) or placebo (n=23) daily for 6 months. Blood samples were analyzed for procoagulant factors (prothrombin, factors VII [fVII], VIII [fVIII], IX [fIX] and XI [fXI], D-dimer and von Willebrand factor [vWf]), anticoagulant factors (antithrombin [AT], total and free protein S, protein C and activated protein C [APC] resistance) and fibrinolytic factors (thrombin activatable fibrinolysis inhibitor [TAFI] and plasminogen activator inhibitor-1 [PAI-1]), at baseline and at 6 months of treatment.Results Estrogen increased factor VII and D-dimer, and decreased antithrombin, total and free protein S and PAI-1. Changes with tamoxifen were distinct from estrogen with increases in factors VIII, IX, vWf and free protein S, and decreases in AT, total protein S, protein C and plasminogen activator inhibitor-1. Raloxifene produced similar effects as tamoxifen, but did not increase factor IX or decrease protein C.Conclusions Estrogen, tamoxifen and raloxifene affected hemostasis favoring procoagulation and impairing anticoagulation. The biochemical effects of the selective estrogen receptor modulators (SERMs) were distinct from those of estrogen and differed only subtly from each other.

Integrity signals

Registry

Crossref · 10.1016/j.thromres.2004.09.014

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Human studies clearly indicate that estrogen treatment results in a prothrombotic state.

    “Human studies clearly indicate that estrogen treatment results in a prothrombotic state.”

    From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [64]

  • Estrogen increases factor VII levels in postmenopausal women.

    “Another study in post-menopausal women showed that estrogen increased factor VII levels, and overall resulted in a pro-thrombotic state [64].”

    From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [64]

  • CHC use decreases plasma levels of tissue factor pathway inhibitor and antithrombin.

    “Studies of the anticoagulant pathway show a decrease in plasma levels of naturally occurring inhibitors of hemostasis such as tissue factor pathway inhibitor and antithrombin with CHC use [63, 64].”

    From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [64]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Cosman, F., Baz-Hecht, M., Cushman, M., Vardy, M. D., Cruz, J. D., Nieves, J. W., Zion, M., & Lindsay, R.
Affiliations
  • Helen Hayes Hospital (US)
  • University of Vermont (US)
  • Englewood Hospital and Medical Center (US)
  • Columbia University Irving Medical Center (US)
Corresponding author
Cosman, F.
ORCID
Venue
Thrombosis Research
Publisher
Elsevier BV
Published
2005-01
Volume
116
Issue
1
Pages
1-13
ISSN
0049-3848 (ISSN-L)
DOI
10.1016/j.thromres.2004.09.014
OpenAlex
W2090476016
Cited by
98
References
76
Citations by year
2026: 3 · 2025: 4 · 2024: 7 · 2023: 9 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 5 · 2013: 6 · 2012: 3
FWCI
6.54
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Thrombosis Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r29dk046381-05)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK-46381)
Topics
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
estrogen therapy, tamoxifen, raloxifene, hemostasis, venous thrombosis, selective estrogen receptor modulators, conjugated equine estrogens, procoagulant factors, anticoagulant factors, fibrinolysis, protein S, protein C, activated protein C resistance, antithrombin III, von Willebrand factor, D-dimer, postmenopausal women
MeSH terms
Blood Coagulation Factors, Estrogens, Female, Fibrinolysis, Hemostasis, Humans, Tamoxifen, Biomarkers, Postmenopause, Blood Coagulation Factor Inhibitors, Thrombophilia, Hormone Replacement Therapy, Selective Estrogen Receptor Modulators, Raloxifene Hydrochloride

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review