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Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke

Overview of attention for article published in Cochrane database of systematic reviews, August 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
6 news outlets
twitter
57 tweeters
facebook
4 Facebook pages
wikipedia
1 Wikipedia page
video
1 video uploader

Citations

dimensions_citation
90 Dimensions

Readers on

mendeley
147 Mendeley
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Title
Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke
Published in
Cochrane database of systematic reviews, August 2015
DOI 10.1002/14651858.cd011054.pub2
Pubmed ID
Authors

Rachel E.J. Roach, Frans M Helmerhorst, Willem M. Lijfering, Theo Stijnen, Ale Algra, Olaf M Dekkers

Abstract

Combined oral contraceptives (COCs) have been associated with an increased risk of arterial thrombosis, i.e. myocardial infarction or ischemic stroke. However, as these diseases are rare in young women and as many types of combined oral contraception exist, the magnitude of the risk and the effect of different hormonal contents of COC preparations remain unclear. To estimate the risk of myocardial infarction or ischemic stroke in users compared with non-users of different types, doses and generations of combined oral contraception. We searched electronic databases (MEDLINE (1966 to July 08, 2015), EMBASE (1980 to July 08, 2015), Popline (1970 to July 08, 2015) and LILACS (1985 to July 08, 2015) for eligible studies, without language restrictions. We included observational studies that recruited women in the reproductive age group (18 to 50 years) and compared the risk of myocardial infarction or ischemic stroke between users and non-users of COCs. Two review authors independently selected relevant studies and extracted data. As not all COC preparations were directly compared in the literature, we performed a network meta-analysis. This allowed preparations to be compared directly or indirectly via a common comparator. We assessed odds ratios (ORs) and 95% confidence intervals (CIs) for myocardial infarction or ischemic stroke in users versus non-users of COCs. We combined the outcomes of myocardial infarction and ischemic stroke and also analysed these outcomes separately. Analyses were stratified according to estrogen dose and progestagen type. In total, we identified 1298 publications through the search strategy. We included 28 publications reporting on 24 studies. COC users were not at increased risk of myocardial infarction or ischemic stroke compared with non-users (OR 1.0, 95% CI 0.9 to 1.0). These ORs were similar for myocardial infarction alone (OR 0.9, 95% CI 0.8 to 1.0) and ischemic stroke alone (OR 1.0, 95% CI 0.9 to 1.1). The risks did not vary according to the generation of progestagen or according to progestagen type. However, when we stratified preparations according to estrogen dose, the risk of myocardial infarction or ischemic stroke seemed to increase with higher doses of estrogen. This network meta-analysis showed that the risk of myocardial infarction or ischemic stroke was only increased in women using COCs containing ≥ 50 µg of estrogen. Regarding myocardial infarction or ischemic stroke, prescribing COCs with < 50 µg of estrogen seems safe. When combined with the results of studies on the risk of venous thrombosis in COC users, it seems that the COC pill containing levonorgestrel and 30 µg of estrogen is the safest oral form of hormonal contraception.

Twitter Demographics

The data shown below were collected from the profiles of 57 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 147 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Germany 1 <1%
Unknown 145 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 30 20%
Student > Bachelor 29 20%
Researcher 20 14%
Other 12 8%
Student > Ph. D. Student 12 8%
Other 29 20%
Unknown 15 10%
Readers by discipline Count As %
Medicine and Dentistry 68 46%
Nursing and Health Professions 19 13%
Biochemistry, Genetics and Molecular Biology 8 5%
Pharmacology, Toxicology and Pharmaceutical Science 6 4%
Agricultural and Biological Sciences 5 3%
Other 19 13%
Unknown 22 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 86. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 January 2020.
All research outputs
#212,073
of 14,282,317 outputs
Outputs from Cochrane database of systematic reviews
#485
of 10,940 outputs
Outputs of similar age
#4,708
of 239,749 outputs
Outputs of similar age from Cochrane database of systematic reviews
#15
of 257 outputs
Altmetric has tracked 14,282,317 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,940 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.8. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 239,749 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 257 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.