Second- and third-generation oral contraceptives and myocardial infarction: Systematic review and meta-analysis

Introduction: Contraceptives are drugs taken to prevent pregnancy and maintain control of the female hormonal cycle. Second-generation contraceptives include levonorgestrel, while third-generation contraceptives are made with desogestrel or gestodene. The objective of this systematic review and meta-analysis is to determine the risk of myocardial infarction when using second- or third-generation oral contraceptives. Materials and methods: A systematic review of observational studies in Medline and Cochrane from 1 January 1996 to 1 June 2015. The meta-analysis was performed using a random effects model. The outcomes are the risk of myocardial infarction due to the use of second- or third generation oral contraceptives. Results: The four observational studies met certain inclusion and quality control criteria. The results of the meta-analysis using the random effects model were 1.0995 for second-generation and 0.8298 for third-generation contraceptives, but these results were not significant. The result of the comparison between third- and second-generation products was also not significant, with a value of 0.7361. Conclusions: We were unable to draw conclusions from the meta-analysis because the results were not significant. We are therefore unable to indicate the whether the risk of myocardial infarction increases with the use of second- or third-generation oral contraceptives. (C) 2016 Elsevier Espana, S.L.U. All rights reserved.