Estrogen levels and risk factors for coronary artery disease in elderly women

Objective: To investigate the correlations between estrogen levels and the characteristics of coronary artery lesions, and risk factors for coronary artery disease (CAD) in elderly women. Methods: A total of 200 elderly women with suspected CAD admitted to Linyi Maternal and Child Health Hospital were recruited in this study and assigned to the CAD group and the non-CAD group according to the results of coronary angiography. Serum estradiol levels, lipid levels and fibrinolytic function of patients were compared between the two groups. Pearson correlation analysis was performed to explore the correlation between estradiol levels and risk factors for CAD. Results: Significantly lower estradiol levels were seen in the patients of the CAD group than those in the non-CAD group (P<0.001). Among the elderly women with CAD affecting one vessel, two vessels or multi vessels, those with the lowest estradiol level were found in the multi-vessel subgroup, whereas those with the highest estradiol level were in the one-vessel subgroup, and the difference was significant (P<0.05). Among the elderly women with various Gensini scores of coronary artery lesions, those with the highest estradiol level were found in the 0-23 scores subgroup while those with the lowest estradiol level were in the 53-188 scores subgroup, and the difference was significant (P<0.05). The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), plasminogen activator inhibitor-1 activity (PAI-1), and von Willebrand factor antigen (vWF: Ag), as well as fibrinogen (Fbg) concentrations in the CAD group were significantly higher than those in the non CAD group, except that the level of plasminogen activator (t-PA) was significantly lower (all P<0.05). Pearson correlation analysis showed that serum estradiol levels were significantly correlated with the levels of TC, TG, LDL-C, t-PA, PAI-1 and vWF: Ag, as well as Fbg concentrations in elderly women with CAD (P<0.05). Conclusion: The estrogen levels of elderly women with CAD decrease more significantly than those of elderly women without CAD. More severe coronary artery lesions indicate lower estrogen levels. Estrogen levels are related to blood lipid levels and fibrinolytic status.