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In an article published in JAMA Cardiology, Dr. Matthew Krasowski and collaborators analyzed cardiac laboratory markers in transgender people

Matthew Krasowski, MD, PhD and  Katie Imborek, MDThe study entitled ‘Distribution of High-Sensitivity Cardiac Troponin and N-terminal Pro-Brain Natriuretic Peptide in Healthy Transgender People’ analyzed high-sensitivity cardiac troponin and N-terminal Pro-Brain Natriuretic Peptide (NT-pro-BNP) serum concentrations in healthy transgender people who had been on gender-affirming hormones (estradiol or testosterone) for at least 12 months.

The study was a collaborative effort between the University of Iowa Hospitals and Clinics (UIHC), University of Washington–Seattle, and several other institutions. Troponin is currently used mainly in the diagnosis and management of myocardial infarction. High-sensitivity cardiac troponin assays, which have come into wide clinical use in the United States in the last 5 years, can measure low concentrations of troponin found in healthy individuals without cardiovascular disease. NT-pro-BNP is principally used in the diagnosis and management of heart failure. It is presumed that normative troponin and NT-pro-BMP levels have been based on cohorts of healthy adult males and females who identified as cisgender (sex assigned at birth aligned with gender identity). Historically, these sex-based differences showed that men have significantly higher troponin concentrations than women, while women have significantly higher NT-pro-BNP concentration than men. The study published in JAMA Cardiology demonstrated that these differences were not based on sex assigned at birth, but rather with exogenous gender-affirming hormone use in the transgender cohort. For example, transgender men taking testosterone had significantly higher troponin concentrations than transgender women taking estrogen, while the reverse was seen with NT-pro-BNP.

The JAMA Cardiology study was a pilot project and highlights the need for larger cardiovascular studies in the transgender population. These findings will help optimize cardiovascular health in this population.

University of Iowa faculty involved in the study were Matthew Krasowski, M.D., Ph.D. (Department of Pathology) and Katie Imborek, M.D. (Department of Family Medicine). The principal investigator in Seattle was Dina Greene, Ph.D., DABCC.

The article can be viewed at: https://doi.org/10.1001/jamacardio.2022.3299.

Monday, November 14, 2022