1. Oestradiol and the risk of myocardial infarction in women: a cohort study of UK Biobank participants.
- Author
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Peters, Sanne A E and Woodward, Mark
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PROPORTIONAL hazards models , *MYOCARDIAL infarction , *ESTRADIOL , *CARDIOVASCULAR diseases risk factors , *SOCIOECONOMIC status , *CARDIOVASCULAR diseases , *COHORT analysis , *RESEARCH , *TISSUE banks , *RESEARCH methodology , *DISEASE incidence , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *RESEARCH funding , *LONGITUDINAL method - Abstract
Background: It is commonly assumed that high oestradiol levels in women are cardioprotective. We assessed the association between oestradiol and the risk of incident myocardial infarction (MI) in women.Methods: We used data from 263 295 female UK Biobank participants [mean age 56.2; standard deviation (SD) 8.0 years] without previous cardiovascular disease (CVD). Associations of oestradiol with age and other cardiovascular risk factors were assessed. Cox proportional hazards models estimated crude, ag- and multiple-adjusted hazard ratios (HR) for MI associated with oestradiol levels.Results: After a mean follow-up of 9 years, 2206 incident cases of MI had been recorded, including 230 events among the 57 204 women (mean age 48) with detectable oestradiol levels. In the unadjusted analyses, a unit higher in log-transformed oestradiol was associated with an HR [95% confidence interval (CI) for MI of 0.73 (0.58; 0.92)]. After adjusting for age, this HR became 0.94 (0.75; 1.17), and after further adjusting for classical CVD risk factors, it was 1.05 (0.83; 1.31. Results were similar in subgroup analyses defined by age, menopausal status, socioeconomic status, contraceptive pill use and the use of hormone replacement therapy. The multivariable-adjusted HR for the 171 431 women (mean age 59) with undetectable levels of oestradiol, compared with those with detectable levels, was 0.97 (0.92; 1.02).Conclusions: Higher levels of oestradiol were not associated with a decreased risk of MI. The presumed cardioprotective effects of oestradiol seem to be largely confounded by age and further confounded by other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]- Published
- 2021
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