Risk for major adverse CV events increases for transgender women after orchiectomy
Click Here to Manage Email Alerts
ANAHEIM, Calif. — Transgender women who undergo a gender-affirming orchiectomy may have an increased risk for major adverse cardiovascular events post-procedure, according to a speaker.
“Orchiectomy may increase the risk of CV events in transgender females,” Thomas Masterson III, MD, assistant professor of urology at the University of Miami Desai Sethi Urology Institute, told Healio. “While this research is mostly hypothesis-generating, it suggests that we should closely monitor this patient population and focus on reduction of other CV risk factors.”
Researchers analyzed data from TriNetX, a multicenter electronic health record database. Adults who had a history of sex reassignment and underwent male to female intersex surgery, acquired absence of other genital organs, surgical laparoscopy, orchiectomy with or without testicular prosthesis, or scrotal or inguinal approach were included. Major adverse CV events included myocardial infarction, venous embolism, cerebral infarction, pulmonary embolism, transient ischemic attack and related syndromes. Researchers collected any major adverse CV events within 5 years of gender-affirming orchiectomy.
The findings were presented at the American Society for Reproductive Medicine Scientific Congress & Expo.
There were 566 transgender women included in the study (mean age, 43 years; 80% white). The cohort had a 6.55% risk for experiencing a major adverse CV event within 5 years of surgery.
The cohort of transgender women were matched with one control cohort of cisgender men and another control cohort of cisgender women who had no history of sex reassignment or orchiectomy. Transgender women were more than twice as likely to have a major adverse CV event after orchiectomy than cisgender men (OR = 2.47; 95% CI, 1.31-4.31; P = .0032) and were more than three times as likely to have a major adverse CV event compared with cisgender women (OR = 3.149; 95% CI, 1.58-5.75; P = .0004).
According to the researchers, the findings revealed a need for providers to evaluate transgender women for preexisting risk factors before undergoing an orchiectomy. Clinical follow-up in the years after surgery is also necessary to monitor CV outcomes.
Masterson said more research is needed to analyze other types of transgender therapies and their effects on CV health.
“The research needs to be validated in a larger population,” Masterson said. “We also need to closely look at and compare other forms of hormonal management.”
Collapse
Carto C, et al. O-52. Presented at: ASRM Scientific Congress & Expo; Oct. 22-26, 2022; Anaheim, California.
Read more about
Click Here to Manage Email Alerts