Abstract
Conclusions and summary
1. In a clinical trial men with coronary artery disease who had recovered from a frank myocardial infarction were randomly treated with Lynoral (ethinyl estradiol), Anvene, Premarin, or a placebo. The 3 estrogen preparations were used in small well-tolerated doses of comparable potency as indicated by mild breast tenderness. 2. No untoward effects of the treatment were observed in up to 60 months of continuous treatment. Changes in libido were rarely noted. 3. Premarin therapy significantly improved survival, particularly in the first 2 years of treatment. Lynoral (ethinyl estradiol) and Anvene had no effect on survival as compared with placebo treatment. 4. Subclasses of patients most likely to benefit from Premarin therapy were those with relatively poor initial prognosis: men under age 55, who had had a first myocardial infarction, and with complications of arteriosclerotic heart disease present. 5. Lynoral (ethinyl estradiol) and Anvene significantly lowered the cholesterol-phospholipid ratio. Premarin had no such effect. 6. There is no necessary correlation between physical response (e.g., breast tenderness), serum lipid and survival effects of estrogen preparations in the male recovering from myocardial infarction: altering of the serum lipids does not necessarily improve survival, and survival may be improved without altering of the serum lipids.
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