TY - JOUR
T1 - Sex hormone levels in patients with sudden cardiac arrest
AU - Narayanan, Kumar
AU - Havmoeller, Rasmus
AU - Reinier, Kyndaron
AU - Jerger, Katherine
AU - Teodorescu, Carmen
AU - Uy-Evanado, Audrey
AU - Navarro, Jo
AU - Huertas-Vazquez, Adriana
AU - Gunson, Karen
AU - Jui, Jonathan
AU - Chugh, Sumeet S.
N1 - Publisher Copyright:
© 2014 Heart Rhythm Society. All rights reserved. Objective The purpose of this study was to study the association between sex hormone levels and sudden cardiac arrest (SCA).
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background Sex hormones are known to have significant effects on the pathophysiology of cardiovascular disease.Methods In the ongoing Oregon Sudden Unexpected Death Study (catchment population approximately 1 million), cases of SCA were compared with matched controls. Testosterone and estradiol levels were measured from blood samples drawn at the time of the SCA event in cases and during a routine visit in controls.Results Among cases (n = 149, age 64.1 ± 11.7 years, 73.2% male), compared to controls (n = 149, 64.2 ± 11.6 years, 72.5% male), median testosterone levels were significantly lower in males (4.4 vs 5.4 ng/mL, P =.01). Median estradiol levels were higher in male (68 vs 52 pg/mL, P <.001) and female cases (54 vs 36 pg/mL, P <.001). In multivariate analysis, higher testosterone levels were associated with lower SCA odds only in males (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.58-0.96, P =.02). Higher estradiol levels were associated with higher SCA odds in both males (OR 2.0, 95% CI 1.5-2.6, P <.001) and females (OR 3.5, 95% CI 1.9-6.4, P <.001). A higher testosterone/estrogen ratio was associated with lower SCA odds in males only (OR 0.5, 95% CI 0.4-0.7, P <.001). In a canine model of SCA, plasma testosterone levels were not significantly altered by the cardiac arrest event.Conclusion We observed significant differences in sex hormone levels in patients who suffered SCA, with potential mechanistic implications. The role of sex hormones in the genesis of fatal ventricular arrhythmias warrants further exploration.
AB - Background Sex hormones are known to have significant effects on the pathophysiology of cardiovascular disease.Methods In the ongoing Oregon Sudden Unexpected Death Study (catchment population approximately 1 million), cases of SCA were compared with matched controls. Testosterone and estradiol levels were measured from blood samples drawn at the time of the SCA event in cases and during a routine visit in controls.Results Among cases (n = 149, age 64.1 ± 11.7 years, 73.2% male), compared to controls (n = 149, 64.2 ± 11.6 years, 72.5% male), median testosterone levels were significantly lower in males (4.4 vs 5.4 ng/mL, P =.01). Median estradiol levels were higher in male (68 vs 52 pg/mL, P <.001) and female cases (54 vs 36 pg/mL, P <.001). In multivariate analysis, higher testosterone levels were associated with lower SCA odds only in males (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.58-0.96, P =.02). Higher estradiol levels were associated with higher SCA odds in both males (OR 2.0, 95% CI 1.5-2.6, P <.001) and females (OR 3.5, 95% CI 1.9-6.4, P <.001). A higher testosterone/estrogen ratio was associated with lower SCA odds in males only (OR 0.5, 95% CI 0.4-0.7, P <.001). In a canine model of SCA, plasma testosterone levels were not significantly altered by the cardiac arrest event.Conclusion We observed significant differences in sex hormone levels in patients who suffered SCA, with potential mechanistic implications. The role of sex hormones in the genesis of fatal ventricular arrhythmias warrants further exploration.
KW - Estradiol
KW - Sudden cardiac arrest
KW - Testosterone
UR - http://www.scopus.com/inward/record.url?scp=84919388266&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84919388266&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2014.08.031
DO - 10.1016/j.hrthm.2014.08.031
M3 - Article
C2 - 25240696
AN - SCOPUS:84919388266
SN - 1547-5271
VL - 11
SP - 2267
EP - 2272
JO - Heart Rhythm
JF - Heart Rhythm
IS - 12
ER -