Effect of estrogen replacement on the progression of coronary artery atherosclerosis - ERA (HRT)


To determine the efficacy of estrogen replacement therapy (ERT) in slowing the progression of coronary artery disease.

Study Design

Study Design:

Patients Enrolled: 309
Mean Patient Age: 55-80
Female: 100

Patient Populations:

Post-menopausal women with at least one non-intervened coronary artery with a luminal diameter lesion at least >30% stenosed.LDL 100-250 mg/dl.


Breast cancer or abnomal mammogram, known or suspected endometrial cancer, abnormal Pap, past DVT or PE, fasting triglycerides >400 mg/dl., etc. etc.

Primary Endpoints:

Progression of angiographically defined coronary heart disease

Secondary Endpoints:

adhesion molecules, endothelium-dependent vasodilatation.

Drug/Procedures Used:

1. Conjugated equine estrogen 0.625 mg. daily and medroxyprogesterone acetate (MPA) 2.5 mg. daily. 2.Conjugated equine estrogen 0.625 mg. daily and medroxyprogesterone acetate (MPA) placebo daily. 3.Conjugated equine estrogen placebo daily and medroxyprogesterone acetate (MPA)placebo daily. Follow up: 3.2 years

Principal Findings:

No significant difference between the three treatment groups was observed neither in the mean luminal diameter at follow-up nor in the change in mean luminal diameter between baseline and follow-up.


Estrogen replacement therapy did not retard atherosclerosis progression in this study.


N Engl J Med 2000; 343: 522-9

Clinical Topics: Atherosclerotic Disease (CAD/PAD)

Keywords: Coronary Artery Disease, Medroxyprogesterone Acetate, Atherosclerosis, Estrogens, Conjugated (USP), Postmenopause, Estrogen Replacement Therapy

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