The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.
Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use
Open accessAbstract
Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the on and off estrogen-containing or progestin-only therapy periods. Cox regression models were fitted, with hormonal therapy (on vs off) as a time-dependent variable to derive the hazard ratio (HR) for the effects on recurrent VTE and abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
In the citing paper
“In a study by Martinelli et al, which analyzed data from the EINSTEIN DVT and Pulmonary Embolism (PE) anticoagulation trials found that women who were on anticoagulation and used CHCs were no more likely to suffer recurrent VTE than women who used progestin-only contraceptives or no hormonal contraceptives[106].”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [106]
In the citing paper
“The study concluded that CHCs did not increase the risk of thrombosis in women who were on therapeutic anticoagulation.”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [106]
In the citing paper
“Prospective data suggests that with therapeutic anticoagulation, estrogen therapy can be safely continued in cisgender women who develop VTE on estrogen [106].”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [106]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Kearon (2012) · doi:10.1378/chest.11-2301 · Cited by 6,119
Self-citationOral Rivaroxaban for Symptomatic Venous Thromboembolism
(2010) · New England Journal of Medicine · doi:10.1056/nejmoa1007903 · Cited by 3,237
Büller (2012) · doi:10.1056/nejmoa1113572 · Cited by 2,353
Medical-eligibility criteria for contraceptive use
Guillebaud, J. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04615-8 · Cited by 1,096
Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion
Henry, D. A., Carless, P. A., Moxey, A. J., O’Connell, D. L., Stokes, B., Fergusson, D. A., & Ker, K. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001886.pub4 · Cited by 1,094
Maternal and fetal sequelae of anticoagulation during pregnancy
Hall, J. G., Pauli, R. M., & Wilson, K. M. (1980) · The American Journal of Medicine · doi:10.1016/0002-9343(80)90181-3 · Cited by 1,003
Jick, H., Jick, S. S., Myers, M. W., Vasilakis‐Scaramozza, C., & Gurewich, V. (1995) · The Lancet · doi:10.1016/s0140-6736(95)91928-7 · Cited by 721
Hormonal contraception and risk of venous thromboembolism: national follow-up study
Lidegaard, O., Lokkegaard, E., Svendsen, A. L., & Agger, C. (2009) · BMJ · doi:10.1136/bmj.b2890 · Cited by 709
Vlieg, A. V. H., Helmerhorst, F. M., Vandenbroucke, J. P., Doggen, C. J. M., & Rosendaal, F. R. (2009) · BMJ · doi:10.1136/bmj.b2921 · Cited by 661
Use of Antithrombotic Agents During Pregnancy
Ginsberg, J. S., & Hirsh, J. (1995) · CHEST Journal · doi:10.1378/chest.108.4_supplement.305s · Cited by 660
Cited by
Sorted by citations
Steffel, J., Verhamme, P., Potpara, T. S., Albaladejo, P., Antz, M., Desteghe, L., Haeusler, K. G., Oldgren, J., Reinecke, H., Roldan-Schilling, V., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy136 · Cited by 2,123
Estrogen and thrombosis: a bench to bedside review
Abou-Ismail, M. Y., Citla Sridhar, D., & Nayak, L. (2020) · Thrombosis Research · doi:10.1016/j.thromres.2020.05.008 · Cited by 261
U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
Nguyen, A. T., Curtis, K. M., Tepper, N. K., Kortsmit, K., Brittain, A. W., Snyder, E. M., Cohen, M. A., Zapata, L. B., Whiteman, M. K., Contributors, et al. (2024) · MMWR Recommendations and Reports · doi:10.15585/mmwr.rr7304a1 · Cited by 288
Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?
Cho, L., Kaunitz, A. M., Faubion, S. S., Hayes, S. N., Lau, E. S., Pristera, N., Scott, N. S., Shifren, J. L., SHUFELT, C. L., Stuenkel, C. A., et al. (2023) · Circulation · doi:10.1161/circulationaha.122.061559 · Cited by 242
Oral Contraceptives and HRT Risk of Thrombosis
Gialeraki, A. E., Valsami, S. I., Pittaras, T., Panayiotakopoulos, G. D., & Politou, M. (2017) · Clinical and Applied Thrombosis/Hemostasis · doi:10.1177/1076029616683802 · Cited by 169
Metadata
- Authors
- Martinelli, I., Lensing, A. W. A., Middeldorp, S., Levi, M., Beyer-Westendorf, J., van Bellen, B., Bounameaux, H., Brighton, T. A., Cohen, A. T., Trajanovic, M., Gebel, M., Lam, P., Wells, P. S., & Prins, M. H.
- Affiliations
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Bayer (Germany) (DE)
- Amsterdam UMC Location University of Amsterdam (NL)
- University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany;
- Department of Vascular Surgery, Beneficencia Portuguesa Hospital, São Paulo, Brazil;
- University Hospital of Geneva (CH)
- Prince of Wales Hospital (AU)
- National Health Service (GB)
- Bayer (United States) (US)
- Bayer HealthCare, Ho Chi Minh, Vietnam;
- University of Ottawa (CA)
- Maastricht University Medical Centre (NL)
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2016-03-17
- Volume
- 127
- Issue
- 11
- Pages
- 1417-1425
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC4832477
- OpenAlex
- W2205757214
- Cited by
- 219
- References
- 50
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 23 · 2023: 13 · 2022: 14 · 2021: 21 · 2020: 26 · 2019: 20 · 2018: 29 · 2017: 18 · 2016: 17
- FWCI
- 21.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- Bristol-Myers Squibb
- Pfizer
- GlaxoSmithKline
- Sanofi
- Government of the United Kingdom
- Bayer HealthCare
- Daiichi Sankyo Europe
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- recurrent venous thromboembolism, abnormal uterine bleeding, hormonal contraception, estrogen-containing contraceptives, progestin-only contraception, vitamin K antagonists, rivaroxaban, enoxaparin, anticoagulation, post-thrombotic syndrome
- MeSH terms
- Rivaroxaban, Adult, Anticoagulants, Contraceptives, Oral, Hormonal, Drug Synergism, Estrogens, Female, Humans, Middle Aged, Progestins, Recurrence, Retrospective Studies, Uterine Hemorrhage, Estrogen Replacement Therapy, Proportional Hazards Models, Randomized Controlled Trials as Topic, Enoxaparin, Venous Thromboembolism, Young Adult
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
