Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women
Giuseppe M. C. Rosano, MD, FACC*,
Carolyn M. Webb, PhD ,
Sergio Chierchia, MD, FACC*,
Gian Luigi Morgani, MD*,
Michele Gabraele, MD*,
Phillip M. Sarrel, MD ,
Dominique de Ziegler, MD and
Peter Collins, MD, FACC
* Department of Cardiology, Ospedale San Raffaele, Rome and Milan, Italy
Cardiac Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, and Royal Brompton and Harefield NHS Trust, London, United Kingdom
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA
Columbia Laboratories, Paris, France
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Figure 1 Flow chart of the study design. Anti-anginal medications were stopped during the run-in phase. Patients were assigned single-blind 17-beta-estradiol (E2; 1 mg/day). On day 18 (D18), this was increased to 2 mg/day and continued for the remainder of the study. Randomization to vaginal progesterone gel (Crinone) or MPA occurred on day 28 (D28) and day 56 (D56). Exercise treadmill testing (ETT) was performed on day 0 (D0), D28, D38, D56 and D66. Long-dashed line = Crinone; short-dashed line = MPA.
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Figure 2 Effects of 17-beta-estradiol treatment alone (E1) and in combination with progesterone gel (P) or MPA on exercise time to the onset of 1-mm ST segment depression. Data are presented as the mean value ± SEM.
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