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Heart attack risk higher in transgender patients
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Transgender patients had an increased risk for MI compared with cisgender patients, according to data presented at the American Heart Association Quality of Care and Outcomes Research Scientific Sessions.
This was seen in all patients except for transgender women vs. cisgender men, according to the study, which was also published in Circulation: Cardiovascular Quality and Outcomes.
“To the best of our knowledge, this is the first cross-sectional study that demonstrates an association between being transgender and reported history of myocardial infarction after adjusting for myocardial infarction risk factors,” Talal Alzahrani, MD, MPH, a cardiology fellow at The George Washington University School of Medicine and Health Sciences in Washington, D.C., and colleagues wrote.
Researchers analyzed data from the Behavioral Risk Factor Surveillance System from 2014 to 2017. Patients included in this study were transgender men (n = 1,267; mean age, 51 years), cisgender women (n = 410,828; mean age, 57 years), transgender women (n = 1,788; mean age, 53 years) and cisgender men (n = 306,046; mean age, 54 years). Surveys were conducted to collect information on MI status, diabetes, hypertension, chronic kidney disease, hypercholesterolemia, age, race/ethnicity, smoking status, physical activity.
Compared with cisgender women, transgender men had more than a fourfold increase in the odds for MI (adjusted OR = 4.9; 95% CI, 2.21-10.9) after adjusting for diabetes, age, smoking, chronic kidney disease, hypercholesterolemia, hypertension and exercise. These increased odds were also seen when compared with cisgender men (aOR = 2.53; 95% CI, 1.14-5.63).
Transgender women had an increased risk for having an MI vs. cisgender women (OR = 2.56; 95% CI, 1.78-3.68). The risk for MI did not significantly differ between transgender women and cisgender men.
“Future studies are required to address how to reduce the rate of myocardial infarction in this population and achieve health equality,” Alzahrani and colleagues wrote.
“Defining gender as more than a binary choice will allow us to gain deeper insights into whether transgender and nonbinary individuals have higher risks for certain outcomes regardless of whether gender is the independent variable of interest,” Paul S. Chan, MD, MSc, professor of medicine at University of Missouri-Kansas City School of Medicine, wrote in a related editorial. “Being intentional about classifying gender as multiple categories will passively generate volumes of research data for cisgender, transgender and nonbinary individuals and rapidly advance our understanding of outcome differences for different gender groups.” – by Darlene Dobkowski
References:
Alzahrani T. QCOR 2019 Early Career Investigator Award Finalists. Presented at: American Heart Association Quality of Care and Outcomes Research Scientific Sessions; April 5-6, 2019; Arlington, Va.
Alzahrani T, et al. Circ Cardiovasc Qual Outcomes. 2019;doi:10.1161/CIRCOUTCOMES.119.005597
Chan PS. Circ Cardiovasc Qual Outcomes. 2019;doi:10.1161/CIRCOUTCOMES.119.005694.
Disclosures: The authors and Chan report no relevant financial disclosures.