Abstract • An alteration in sex hormones has been considered a risk factor for myocardial infarction. In this study, estradiol (E2) and testosterone (T) levels were evaluated in healthy firefighters, patients with myocardial infarction acutely and during their convalescence, patients with no evidence of occlusive coronary artery disease on arteriography, and patients with chronic angina pectoris in whom there was at least one vessel that indicated 50% occlusive coronary artery disease. Although T levels were similar in all groups, E2 levels were substantially higher in patients with myocardial infarction and in patients with chronic angina pectoris. These results support the hypothesis that elevated estrogen levels may be a risk factor for myocardial infarction and coronary artery disease, possibly by promoting clotting or coronary spasm. (Arch Intern Med 1982;142:42-44) References 1. Phillips GB: Evidence for hyperestrogenemia as a risk factor for myocardial infarction in men. Lancet 1976;2:14-18.Crossref 2. Phillips GB: Relationship between serum sex hormones and glucose, insulin, and lipid abnormalities in men with myocardial infarction. Proc Natl Acad Sci USA 1977;74:1729-1733.Crossref 3. Phillips GB: Sex hormones, risk factors and cardiovascular disease. Am J Med 1978;65:7-11.Crossref 4. Entrican JH, Beach C, Carroll D, et al: Raised plasma oestradiol and oestrone levels in young survivors of myocardial infarction. Lancet 1978;2:487-490.Crossref 5. Zamponga A, Luria MH, Manubens SJ, et al: Relationship between lipids and occlusive coronary artery disease. Arch Intern Med 1980;140:1067-1069.Crossref 6. Korenman SG, Stevens RS, Carpenter LA, et al: Estradiol radioimmunoassay without chromatography: Procedure, validation and normal values. J Clin Endocrinol Metab 1974;38:718-720.Crossref 7. Chen JC, Zorn EM, Hallberg MC, et al: Antibodies to testosterone-3-bovine serum albumin, applied to assay of serum 17β-ol androgens. Clin Chem 1971;17:581-584. 8. Schneider G, Kirschner MA, Berkowitz R, et al: Increased estrogen production in obese men. J Clin Endocrinol Metab 1979;48:633-638.Crossref 9. Afifi AA, Azen SP: Statistical Analysis: A Computer-Oriented Approach . New York, Academic Press Inc, 1972, pp 212-221. 10. Seltzer CC: Some re-evaluations of the build and blood pressure study, 1959, as related to the ponderal index, somatotype and mortality. N Engl J Med 1966;274:254-259.Crossref 11. Bray GA, Jordan HA, Sims EAH: Evaluation of the obese patient. JAMA 1976;235:1487-1491.Crossref 12. Guevara A, Luria MH, Wieland RG: Serum gonadotropin levels during medical stress (myocardial infarction). Metabolism 1970;19:79-83.Crossref 13. The coronary drug project: Initial findings leading to modifications of its research protocol, The Coronary Drug Project Research Group. JAMA 1970;214:1303-1313.Crossref 14. Stumpf WE, Sar M, Aumuller G: The heart: A target organ for estradiol. Science 1977;197:319-321.Crossref 15. Harder DR, Coulson PB: Estrogen receptors and effects of estrogen on membrane electrical properties of coronary vascular smooth muscle. J Cell Physiol 1979;100:375-382.Crossref 16. McGill HC, Sheridan PJ: Nuclear uptake of sex steroid hormones in the cardiovascular system of the baboon. Circ Res 1981;48:238-244.Crossref 17. Jaffe MD: Effect of oestrogens on postexercise electrocardiogram. Br Heart J 1976;38:1299-1303.Crossref 18. Oliva PB, Breckinridge MD: Arteriographic evidence of coronary arterial spasm in acute myocardial infarction. Circulation 1977;56:366-374.Crossref 19. Maseri A, L'Abbate A, Baroldi G, et al: Coronary vasospasm as a possible cause of myocardial infarction: A conclusion derived from the study of 'preinfarction' angina. N Engl J Med 1978;299:1271-1277.Crossref 20. Oestrogens, calcium transport, and coronary spasm, editorial. Lancet 1977;1:229-230. 21. Masi AT, Dugdale M: Cerebrovascular diseases associated with the use of oral contraceptives: A review of the English-language literature. Ann Intern Med 1970;72:111-121.Crossref 22. Marzilli M, Goldstein S, Trivella MG, et al: Some clinical considerations regarding the relation of coronary vasospasm to coronary atherosclerosis: A hypothetical pathogenesis. Am J Cardiol 1980;45:882-886.Crossref 23. Longcope C, Kato T, Horten R: Conversion of blood androgens to estrogens in normal adult men and women. J Clin Invest 1969;48:2191-2201.Crossref 24. Pirke KM, Doerr P: Age related changes and interrelationships of plasma testosterone, oestradiol, and testosterone-binding globulin in normal adult males. Acta Endocrinol 1973;74:792-800.
Archives of Internal Medicine – American Medical Association
Published: Jan 1, 1982