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Randomised controlled trial
Whether the use of unopposed oestrogen following a myocardial infarction is beneficial or harmful remains unclear, and in individual women the effects may vary according to the underlying risk profile
  1. Samuel Shapiro
  1. Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town Medical School, Cape Town, South Africa
  1. Correspondence to : Professor Samuel Shapiro, Faculty of Health Sciences, School of Public Health and Family Medicine, Falmouth Building, University of Cape Town, Observatory, 7925, South Africa; samshap{at}

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There is a biological and epidemiological evidence to suggest that high oestrogen levels retard the progression of atherogenesis, reducing the risk of myocardial infarction. Whether such an effect is evident following a first myocardial infarction is unclear. A randomised controlled trial was carried out to investigate. Following completion of the trial the authors continued the follow-up in order to evaluate the long-term safety of unopposed oestrogen.


Women aged 50–79 years who sustained a first myocardial infarction (MI) and who had not used hormone replacement therapy in the preceding year were randomised …

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  • Competing interests SS has in the past consulted, and presently consults with, Bayer Schering and with other manufacturers of female hormones.

  • Provenance and peer review Not commissioned; internally peer reviewed.