VPB1389 - Descriptive analysis of venous thromboembolic disease in patients under contraceptive treatment in sector III of Aragón

Background: In the present study, we analysed the profile of women, users of contraceptives, who have suffered a thrombotic event, to identify predisposing factors in order to minimise the risk and to be able to prescribe these drugs more safely.

Aims: To describe the type of thrombotic event in women taking contraceptives and to identify the environmental factors that precipitate and contribute to the magnitude of the event.

Methods: Observational, descriptive, cross-sectional and retrospective study of a cohort of patients diagnosed with thrombosis while taking hormonal contraceptives from 2010 to 2020. Epidemiological, clinical and biological data were obtained from computerised medical records, the Emergency Department and the GOTA programme of patients seen at the Hospital Clínico Lozano Blesa in Zaragoza. The bibliography was obtained from electronic databases.

Results: The study population consisted of 190 women, of whom 52 met the inclusion criteria. 9.6% had a family history of VTE. The CVRFs present were: smoking (34.6%), obesity (29%), dyslipidaemia (17%) and arterial hypertension (4%); medical comorbidities: autoimmune disease (15.5%), mental illness (15.5%), respiratory pathology (11.5%), chronic venous insufficiency (9.6%), neoplastic disease (4%); environmental risk factors (30.8%); type of contraceptive: combined (79%), gestagen only (2%), no information (19%); gestagen generation: second (9.8%), third (34.2%) and fourth (56%); clinical manifestations of VTE: DVT (69.2%), PE (40.4%), DVT + PE (17.3%), SVT (5.8%), DVT + SVT (4%) and others locations (2%); positive thrombophilia (34.6%); recurrence of VTE (2%).

Conclusion(s): 1. The most common clinical manifestation of VTE in women who experience thrombosis in the context of contraceptive use is proximal DVT of the lower extremities.
2. The risk of VTE from contraceptives is determined by both the dose of oestrogen and the type of progestogen. The safest option is an oral contraceptive containing levonorgestrel combined with a low dose of estrogen (20 mg).