(Circulation. 1997;96:3774-3777.)
© 1997 American Heart Association, Inc.
Articles |
Premature Coronary Artery Disease Associated With a Disruptive Mutation in the Estrogen Receptor Gene in a Man
From the Cardiology Division, Department of Medicine (K.S., T.M.C., K.C.) and the Cardiovascular Research Institute (J.P.K., M.J.M., K.S., T.M.C., K.C.), University of California, San Francisco; the Division of Endocrinology, Children's Hospital Medical Center (E.P.S.) and the Division of Endocrinology, University of Cincinnati (Ohio) College of Medicine (T.C.W.); National Institutes of Environmental Health Sciences, Research Triangle Park, NC (K.S.K.); and Berlex Biosciences, Richmond, Calif (G.M.R.). Correspondence to K. Sudhir, MD, PhD, Box 0124, University of California, San Francisco, CA 94143-0124.
Background While estrogens protect against coronary artery disease in women, it is unclear whether they influence cardiovascular function in men. The present report describes coronary vascular abnormalities and the lipoprotein profile of a male patient with estrogen insensitivity caused by a disruptive mutation in the estrogen-receptor gene.
Methods and Results Stress thallium scintigraphy, echocardiography, and electron-beam computed tomography (CT) scanning of the coronary arteries and detailed lipoprotein analysis were performed. Electron-beam CT scanning of the coronary arteries showed calcium in the left anterior descending artery. Lipoprotein analysis showed relatively low levels of total (130 mg/dL), LDL (97 mg/dL), and HDL (34 mg/dL) cholesterol; apolipoprotein A-I (91.7 mg/dL;); and lipoprotein(a) (4.1 nmol/L), but normal levels of triglycerides (97 mg/dL) and pre-ß-1-HDL cholesterol (61 µg/mL).
Conclusions The absence of functional estrogen receptors may be a novel risk factor for coronary artery disease in men.
Key Words: estrogen • men • coronary disease
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