Venous and arterial thromboembolic disease in women using oral contraceptives

  • Katherine E. Miller
    Department of Pathology, Duke University Medical Center Durham, North Carolina USA

    Department of Biochemistry, Duke University Medical Center Durham, North Carolina USA
    Search for articles by this author
  • Salvatore V. Pizzo
    Reprint requests: Dr. Salvatore V. Pizzo, Box 3712, Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710
    Department of Pathology, Duke University Medical Center Durham, North Carolina USA

    Department of Biochemistry, Duke University Medical Center Durham, North Carolina USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Vascular plasminogen activator was measured by means of a new chromogenic assay in 24 women who had suffered from oral contraceptive-associated thrombotic disease and was compared to that in a control group of 78 premenopausal women. Vascular plasminogen activator levels were significantly reduced in the subjects who had venous thrombosis but not in the five women who had arterial thrombosis (0.04 ± 0.03 versus 0.38 ± 0.31, respectively) when compared to the levels in the control group (0.19 ± 0.20). Since vascular activator levels distribute in a non-Gaussian manner, cases and controls were also stratified into deciles. Seventeen subjects who had suffered from venous thrombosis were stratified in the lowest three deciles, and two subjects, in the fourth and fifth deciles. Subjects who had suffered from arterial thrombosis were in the fourth or higher deciles. The conclusion is that, although there is a correlation between low levels of vascular plasminogen activator and venous thrombosis, no such correlation exists for arterial thrombosis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Stadel B.V.
        Oral contraceptives and cardiovascular disease.
        N. Engl. J. Med. 1981; 305: 612
        • Arkin C.F.
        • Hartman A.S.
        The hypercoagulability states.
        CRC Crit. Rev. Clin. Lab. Sci. 1979; 11: 397
        • Conard J.
        • Cazenave B.
        • Samama M.
        • Horellou M.H.
        • Zorn J.R.
        • Neau C.
        AT-III content and antithrombin activity in oestrogen-progestogen and progestogen-only treated women.
        Thromb. Res. 1980; 18: 675
        • Wessler S.
        • Gitel S.N.
        • Wan L.S.
        • Pasternack B.S.
        Estrogen-containing oral contraceptive agents: A basis for their thrombogenicity.
        JAMA. 1976; 236: 2179
        • Isacson S.
        • Nilsson I.M.
        Defective fibrinolysis in blood and vein walls in recurrent “idiopathic” venous thrombosis.
        Acta Chir. Scand. 1972; 138: 313
        • Astedt B.
        • Isacson S.
        • Nilsson I.M.
        • Pandolfi M.
        Thrombosis and oral contraceptives: Possible predisposition.
        Br. Med. J. 1973; 4: 631
        • Pizzo S.V.
        • Lewis J.G.
        • Campbell E.E.
        • Dreyer N.A.
        Fibrinolytic response and oral contraceptive associated thromboembolism.
        Contraception. 1981; 23: 181
        • Campbell E.E.
        • Shifman M.A.
        • Pasqua J.J.
        • Pizzo S.V.
        A chromogenic assay for releasable plasminogen activator.
        Clin. Chem. 1982; 28: 1125
        • Dreyer N.A.
        • Pizzo S.V.
        Blood coagulation and idiopathic thromboembolism among fertile women.
        Contraception. 1980; 22: 123
        • Sartwell P.E.
        • Masi A.T.
        • Arthes F.G.
        • Greene G.R.
        • Smith H.E.
        Thromboembolism and oral contraceptives: An epidemiologic case-control study.
        Am. J. Epidemiol. 1969; 90: 365
        • Deutsch D.G.
        • Mertz E.T.
        Plasminogen: Purification from human plasma by affinity chromatography.
        Science. 1970; 170: 1095
        • Williams R.S.
        • Logue E.E.
        • Lewis J.L.
        • Barton T.K.
        • Stead N.W.
        • Wallace A.G.
        • Pizzo S.V.
        Physical conditioning augments the fibrinolytic response to venous occlusion in healthy adults.
        N. Engl. J. Med. 1980; 302: 987
        • Croxton F.E.
        ed. 2. Elementary Statistics With Applications in Medicine. Dover Press, New York1959: 267-283
      1. Stead, N. W., Bauer, K. A., Kinney, T. R., Lewis, J. G., Campbell, E. E., Shifman, M. A., Rosenberg, R. D., and Pizzo, S. V.: Venous thrombosis in a family with defective release of vascular plasminogen activator and elevated plasma factor VIII/von Willebrand factor, Am. J. Med. In press.

        • Wu K.K.
        • Hoak J.C.
        A new method for qualitative detection of platelet aggregates in patients with arterial insufficiency.
        Lancet. 1974; 2: 924