Key result
Among young to middle-aged women with no clinical coronary artery disease, high free testosterone was associated with significantly higher odds of high-risk plaque features (aOR 3.48).
Why the study?
The association of sex-specific hormones with CCTA-based plaque characteristics in women without cardiovascular disease is not well understood.
Cross-Sectional (n=2,325)
No
In young to middle-aged women without clinical CAD, higher free testosterone is associated with high-risk coronary plaque features, suggesting a potential role for androgenic hormones in subclinical atherosclerosis.
Answers are grounded in this paper and cite their sources.
High free testosterone was associated with high-risk plaque in women without CAD; hypothesis-generating for androgen effects and requires prospective validation.
Objective: The association of sex-specific hormones with coronary computed tomography angiography(CCTA)-based plaque characteristics in women without cardiovascular disease is not well understood. We investigated the association of sex-specific hormones with coronary artery plaque characteristics in a contemporary multiracial cohort with no clinical coronary artery disease (CAD). Methods: In this cross-sectional analysis, we utilized data from 2,325 individuals with no clinical CAD from the Miami Heart (MiHeart) study. Multivariable logistic regression models were used to investigate the association of sex hormones: sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), free and total testosterone, estradiol, with plaque characteristics among women and men. Results: = 1170), 63.1% had any plaque and 10.4% had HRP. Among women, estradiol and SHBG were associated with lower odds of any plaque after adjusting for age and race-ethnicity (estradiol OR per SD increase: 0.87, 95%CI: 0.76-0.98; SHBG OR per SD increase: 0.82, 95%CI: 0.72-0.93) but the significance did not persist after adjustment of cardiovascular risk factors. High free testosterone was associated with higher odds of HRP (aOR:3.48, 95%CI:1.07-11.26) but null associations for the other sex hormones with HRP, in the context of limited sample size. Among men, there were no significant associations between sex-specific hormones and plaque or HRP. Conclusion: Among young to middle-aged women with no clinical CAD, increasing estradiol and SHBG were associated with lower odds of any plaque and higher free testosterone was associated with HRP. Larger cohorts may be needed to validate this.
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Kwapong et al. (2023) conducted a cross-sectional in No clinical coronary artery disease (n=2,325). High free testosterone vs. Low/normal free testosterone was evaluated on Presence of high-risk plaque (HRP) features on CCTA in women (aOR 3.48, 95% CI 1.07-11.26). Among young to middle-aged women with no clinical coronary artery disease, high free testosterone was associated with significantly higher odds of high-risk plaque features (aOR 3.48).
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