The Living Guidelines: UA/NSTEMI Recommendations for Hormone Therapy View the Current CLASS I Guidelines

1. Hormone therapy with estrogen plus progestin, or estrogen alone, should not be given de novo to postmenopausal women after UA/NSTEMI for secondary prevention of coronary events. (Level of Evidence: A)

2. Postmenopausal women who are already taking estrogen plus progestin, or estrogen alone, at the time of UA/NSTEMI in general should not continue hormone therapy.

However, women who are more than 1 to 2 years past the initiation of hormone therapy who wish to continue such therapy for another compelling indication should weigh the risks and benefits, recognizing the greater risk of cardiovascular events and breast cancer (combination therapy) or stroke (estrogen). Hormone therapy should not be continued while patients are on bed rest in the hospital. (Level of Evidence: B)

Reference: 1- Anderson JL, Adams CD, Antman EM et. al, ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/NonST-Elevation Myocardial Infarction. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction). Circulation published online Aug 6, 2007; DOI: 10.1161/CIRCULATION AHA.107.181940