Fibrinolytic potential is significantly increased by oestrogen treatment in postmenopausal women with mild dyslipidaemia.

OBJECTIVE To study the effects of oestrogen replacement treatment on fibrinolytic potential in postmenopausal women. DESIGN Randomised, double blind, placebo controlled trial of oral 17 beta-oestradiol. SETTING Subjects were evaluated in the outpatient setting. PATIENTS Nineteen postmenopausal women with mild dyslipidaemia, aged 44 to 69 years (mean (SD) 55.7 (6.7)). MAIN OUTCOME MEASURES Fibrinolytic activity (fibrin plate assay) and tissue plasminogen activator (t-PA) antigen were measured at baseline and after three, six, and nine weeks of each treatment. RESULTS After nine weeks of 2 mg oestradiol treatment, there was a significant increase in fibrinolytic potential compared with placebo, as indicated by an increase in fibrinolytic activity (mean (SEM), 80 (9) v 54 (5) mm2 of lysis in the fibrin plate, 2 mg v placebo, p = 0.002) and a decrease in t-PA antigen (5.8 (0.9) v 8.4 (1.2) ng/ml, 2 mg v placebo, p < 0.001). There was a similar trend with the 1 mg dose but the changes were less noticeable. CONCLUSIONS Hormone replacement treatment with 17 beta-oestradiol for nine weeks significantly increased fibrinolytic potential in postmenopausal women with mild dyslipidaemia. This suggests that the cardioprotective effect of oestrogen may be mediated, in part, by an increase in fibrinolytic potential.