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Testosterone-to-estradiol ratio and platelet thromboxane release in ischemic heart disease: the EVA project.
- Source :
-
Journal of endocrinological investigation [J Endocrinol Invest] 2022 Jul; Vol. 45 (7), pp. 1367-1377. Date of Electronic Publication: 2022 Mar 09. - Publication Year :
- 2022
-
Abstract
- Background: Data on the interplay between sexual hormones balance, platelet function and clinical outcomes of adults with ischemic heart disease (IHD) are still lacking.<br />Objective: To assess the association between the Testosterone (T)-to-Estradiol (E2) Ratio (T/E2) and platelet activation biomarkers in IHD and its predictive value on adverse outcomes.<br />Methods: The EVA study is a prospective observational study of consecutive hospitalized adults with IHD undergoing coronary angiography and/or percutaneous coronary interventions. Serum T/E2 ratios E2, levels of thromboxane B <subscript>2</subscript> (TxB <subscript>2</subscript> ) and nitrates (NO), were measured at admission and major adverse events, including all-cause mortality, were collected during a long-term follow-up.<br />Results: Among 509 adults with IHD (mean age 67ā±ā11 years, 30% females), males were older with a more adverse cluster of cardiovascular risk factors than females. Acute coronary syndrome and non-obstructive coronary artery disease were more prevalent in females versus males. The lower sex-specific T/E2 ratios identified adults with the highest level of serum TxB <subscript>2</subscript> and the lowest NO levels. During a median follow-up of 23.7 months, the lower sex-specific T/E2 was associated with higher all-cause mortality (HR 3.49; 95% CI 1.24-9.80; pā=ā0.018). In in vitro, platelets incubated with T/E2 ratios comparable to those measured in vivo in the lowest quartile showed increased platelet activation as indicated by higher levels of aggregation and TxB <subscript>2</subscript> production.<br />Conclusion: Among adults with IHD, higher T/E2 ratio was associated with a lower long-term risk of fatal events. The effect of sex hormones on the platelet thromboxane release may partially explain such finding.<br /> (© 2022. The Author(s).)
Details
- Language :
- English
- ISSN :
- 1720-8386
- Volume :
- 45
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of endocrinological investigation
- Publication Type :
- Academic Journal
- Accession number :
- 35262860
- Full Text :
- https://doi.org/10.1007/s40618-022-01771-0