Assessment of the Thrombophilic Risk in Women Candidates to Hormone Replacement Therapy

Abstract number: P2280

Consiglio¹ P, De Michele¹ S, Salvia¹ M, Tusa¹ G, Calabrò¹ G, Aiosa¹ A, Di Maio¹ C, Maratta¹ A, Vitale¹ G, Amato¹ G, Lombino¹ F, Ferraro² L, Menozzi¹ I, A.R.N.A.S Ospedale Civico, Palermo, Italy 

¹¹Laboratorio Analisi, Xx, Xx ¹¹Laboratorio Analisi, Xx, Xx ²²Divisione di Ginecologia, Xx, Xx

Aim:  to apply a score-based assessment tool of the thrombotic risk in women in menopause to be treated with hormone replacement therapy (HRT).

Hormone replacement therapy in menopause is associated with a significantly higher thrombotic risk, as reported in the current literature on the thromboembolism predisposing factors. In agreement with the gynaecologists of our hospital, we prepared an anamnestic-diagnostic questionnaire for the thromoboembolic risk assessment, to be administered before performing specialistic laboratory tests. The features of the possibly HRT-treated women in menopause that we considered in our questionnaire are: thrombosis family and personal history, age, obesity, smoking habits, hypertension, diabetes mellitus, hypercholesterolemia, malignancy, psychotropic drugs and obstetric pathology. We assigned a score ranging from 0 to 5 to each factor according to the risk level. The scale has been designed on case-control and cohort studies from the current literature. Therefore patients are spitted in two groups: low risk women with a total score <=5 and average or high risk women with a total score >5. Women with average or high risk will undergo neither HRT nor specialistic laboratory tests. Women with low risk will be screened for thrombophilia, including basic coagulative tests, physiological inhibitors, omocysteinemia, antiphospholipid antibodies and genetic mutations for Factor V, Factor II and MTHFR. A positive result in the thrombophilic study excludes the treatment with HRT. Only women with risk <=5 are fit for the HRT. Both low risk groups, either using HRT or not, will have been monitoring for 2 years in a prospectic study to consider the possible appearance of thromboembolic events.

Conclusions:  the use of this questionnaire allows a better selection of the patients for HRT and a reduction of the necessary specialistic tests. The recent introduction of the questionnaire does not permit to present a statistical analysis. Samama M.M,Haem.2001.Conard J,PHT,2004.