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The association of hyperestrogenemia with coronary thrombosis in men
G B Phillips1, B H Pinkernell, T Y Jing
1Department of Medicine, Columbia University College of Physicians and Surgeons, St. Luke's-Roosevelt Hospital Center, New York, NY, USA.
Insights
Elevated estradiol levels, a form of hyperestrogenemia, were significantly associated with myocardial infarction (MI) in men. This finding suggests a potential link between high estrogen and the blood clots causing heart attacks.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Thrombosis Research
Background:
- Both high estrogen (hyperestrogenemia) and low testosterone (hypotestosteronemia) have been linked to myocardial infarction (MI) in men.
- Previous research indicated a negative correlation between serum testosterone and coronary artery disease (CAD) severity in men without a history of MI.
Purpose of the Study:
- To investigate the relationship between sex hormone levels and the thrombotic component of MI.
- To compare sex hormone levels in men who experienced an MI (thrombosis) versus those without MI (no thrombosis) but with similar CAD severity.
Main Methods:
- Compared sex hormone levels in 18 men with a history of MI to 50 men without MI.
- Ensured comparable degrees of CAD, age, and body mass index between the groups.
- Utilized multivariate logistic regression to identify significant predictors of MI.
Main Results:
- Men with MI had significantly higher mean serum estradiol levels (38.5 pg/mL) compared to men without MI (31.9 pg/mL).
- No significant differences were observed in mean levels of testosterone, free testosterone, SHBG, insulin, DHEAS, lipids, or blood pressure.
- Estradiol was the sole variable significantly associated with MI (P < .003).
Conclusions:
- Hyperestrogenemia, specifically elevated estradiol, may be implicated in the thrombosis associated with myocardial infarction in men.
- These findings highlight a potential role for estrogen in the pathogenesis of MI-related thrombosis.
Abstract:
Both hyperestrogenemia and hypotestosteronemia have been reported in association with myocardial infarction (MI) in men. It was previously observed that the serum testosterone concentration correlated negatively with the degree of coronary artery disease (CAD) in men who had never had a known MI. The present study investigated the relationship of sex hormone levels to the thrombotic component of MI by comparing these levels in 18 men who had had an MI (ie, thrombosis) and 50 men with no history of MI (ie, no thrombosis) whose degree of CAD was in the same range. The mean degree of CAD, age, and body mass index in these two groups was not significantly different. The mean serum estradiol level in the men who had had an MI (38.5 +/- 8.8 pg/mL) was higher (P = .002) than the level in the men who had not had an MI (31.9 +/- 7.1 pg/mL). The mean levels of testosterone, free testosterone, sex hormone-binding globulin, insulin, dehydroepiandrosterone sulfate, cholesterol, HDI, cholesterol, and systolic and diastolic blood pressure did not differ significantly. Estradiol was the only variable measured that showed a significant relationship to MI (P < .003 by multivariate logistic regression). These findings suggest that hyperestrogenemia may be related to the thrombosis of MI.