Testosterone, estradiol and their ratio in male patients with acute coronary syndrome

The role of androgens and estrogens in cardiovascular disease is a subject of ongoing studies. Therefore, we aim to explore the association of testosterone (T), estradiol and their ratio with cardiovascular risk factors and severity of cardiac ischemia in male patients with acute coronary syndrome. (ACS) n = 72 and controls (n = 35) Lower values of both total and free T were found in the ACS group compared to controls (8.97 vs. 10.98 nmol/l, p = 0.001 for total T and 0.189 vs. 0.223 nmol/l, p = 0.006 for free T). Patients with myocardial infarction with ST-elevation had significantly lower T fractions compared to ACS without ST-elevation. The T to estradiol ratio was significantly lower in the ACS group compared to controls and is lowest in those with STEMI. Also, all testosterone fractions – free, bioavailable, and free T, are lower in patients with ACS compared to controls. Based on these observations a conclusion can be drawn that amore estrogenic environment is associated with ST-elevation and correlates with the severity of ACS in male patients.