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Objective: To compare the effects of estrogen and estrogen plus progestin on levels of C-reactive protein(CRP)and interleukin-6(IL-6), and to examine the relationship between these changes and progression of angiographically defined coronary disease. Methods: Baseline and follow-up(year 1 and year 3)plasma levels of IL-6 and CRP were measured in a subset of 232 patients from the Estrogen Re placement in Atherosclerosis(ERA)trial. Results: Serial angiograms were also ava ilable at baseline and closeout. Estrogen alone increased CRP by 40%(P=.01)at 1 year and 38%(P=.002)at closeout. Estrogen plus medroxyprogesterone acetate inc reased CRP by 44.7%(P=.001)at 1 year and 54.7%(P=.0001)at closeout as compared with baseline levels. There were no significant changes in IL-6 with either tr eatment. In women in the active treatment arm, change in CRP during the first ye ar was not associated with progression of coronary disease (P=.2). Conclusions: Estrogen and estrogen plus medroxyprogesterone significantly raise CRP levels in women with established coronary disease. In contrast, IL-6 levels are not affe cted by estrogen or estrogen plus progestin. Estrogen-induced changes in CRP ar e not associated with progression of atherosclerosis.
Objective: To compare the effects of estrogen and estrogen plus progestin on levels of C-reactive protein (CRP) and interleukin-6 (IL-6), and to examine the relationship between these changes and progression of angiographically defined coronary disease. Methods: Baseline and follow-up (year 1 and year 3) plasma levels of IL-6 and CRP were measured in a subset of 232 patients from the Estrogen Re placement in Atherosclerosis (ERA) trial. Results: Serial angiograms were also ava ilable at baseline Estrogen plus increased CRP by 40% (P = .01) at 1 year and 38% (P = .002) at closeout. Estrogen plus medroxyprogesterone acetate inc reased CRP by 44.7% (P = .001) at 1 year There were no significant changes in IL-6 with either tr eatment. In women in the active treatment arm, change in CRP during the first ye ar was not associated with progression of coronary disease (P = .2). Conclusions: Estrogen and estrogen plus medroxyprogesterone significantly elevated CRP levels in women with established coronary disease. In contrast, IL-6 levels are not affected by estrogen or estrogen plus progestin. Estrogen-induced changes in CRP ar e not associated with progression of atherosclerosis.