TY - JOUR T1 - 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 JF - Evidence Based Medicine JO - Evid Based Med SP - 195 LP - 195 DO - 10.1136/ebmed-2014-110043 VL - 19 IS - 5 AU - Samuel Shapiro Y1 - 2014/10/01 UR - http://ebm.bmj.com/content/19/5/195.abstract N2 - Commentary on: Cherry N, McNamee R, Heagerty A, et al. Long-term safety of unopposed oestrogen used by women surviving myocardial infarction: a 14-year follow-up of the ESPRIT randomised controlled trial. BJOG 2014;121:700–5; discussion 705.OpenUrlCrossRefPubMed 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 … ER -