Impaired estrogen (E2) action is important for cardiovascular disease (CAD) in both men and women. Associations of CAD with estrogen receptor polymorphisms, which may influence sensitivity to E2 have been reported for men but have not been confirmed for women. The aim of the present study was to investigate the association of estrogen receptor common polymorphisms with the severity of coronary disease in women undergoing coronary angiography.
Estrogen receptor alpha polymorphisms at positions c.454397 T>C (PVU2) and c.454351 A>G (Xba1) were studied in 129 postmenopausal women (age 3788 yrs). The severity of CAD was assessed by the number of arteries (0, 1, 2 or 3) with >50% stenosis in the angiography. The protocol was approved by the Institutions ethical committee. Patients gave their informed consent. Biochemical parameters were assessed.
60 women had 0 vessel disease, 27 had 1, 27 had 2 and 15 had 3 vessel disease. Several classical risk factors for CAD were significantly associated with the severity of CAD, such as smoking, hyperlipidemia, positive family history, waist perimeter and the presence of diabetes mellitus. There was a significant association between the TT, TC and CC genotypes (PVU2) and the severity of CAD (P<0.01, Mantel Haenzel test for linear association); similar results were obtained with the Xba1 polymorphism.
We conclude that common estrogen receptor alpha polymorphisms probably affecting sensitivity to estrogen may influence the severity of CAD in women undergoing coronary angiography, as they probably reflect the life time exposure to estrogen. Similar associations have been reported for men with coronary artery disease. These polymorphisms should probably be taken into account when associations with estrogen action are examined.