Raparelli, V, Nocella, C, Proietti, M 
ORCID: 0000-0003-1452-2478, Romiti, GF, Corica, B ORCID: 0000-0001-9460-4435, Bartimoccia, S, Stefanini, L, Lenzi, A, Viceconte, N, Tanzilli, G et al (show 5 more authors)
(2022)
Testosterone-to-estradiol ratio and platelet thromboxane release in ischemic heart disease: the EVA project.
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 45 (7).
pp. 1367-1377.
Abstract
<h4>Background</h4>Data on the interplay between sexual hormones balance, platelet function and clinical outcomes of adults with ischemic heart disease (IHD) are still lacking.<h4>Objective</h4>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.<h4>Methods</h4>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<sub>2</sub> (TxB<sub>2</sub>) and nitrates (NO), were measured at admission and major adverse events, including all-cause mortality, were collected during a long-term follow-up.<h4>Results</h4>Among 509 adults with IHD (mean age 67 ± 11 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<sub>2</sub> 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; p = 0.018). 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<sub>2</sub> production.<h4>Conclusion</h4>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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Testosterone, Estradiol, Ischemic heart disease, Thromboxane, Mortality |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 13 May 2022 15:04 |
| Last Modified: | 18 Jan 2023 21:03 |
| DOI: | 10.1007/s40618-022-01771-0 |
| Open Access URL: | https://link.springer.com/article/10.1007/s40618-0... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3154769 |
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