Turner syndrome (TS) is associated with coronary artery disease (CAD), an important cause of premature death in TS. However, the determinants of CAD in women with TS remain unknown. In a cross-sectional study design, 168 women without clinical evidence of CAD (115 with TS and 53 without TS) were assessed for the presence and volume of subclinical CAD using coronary CT angiography. Karyotype, the presence of congenital heart defects and conventional cardiovascular risk factors were also registered. Comparative analyses were performed (1) between women with and without TS and (2) in the TS group, between women with and without subclinical CAD. The prevalence of CAD, in crude and adjusted analyses, was not increased for women with TS (crude prevalence: 40 [35%] in TS vs. 25 [47%] in controls, p = 0.12). The volume of atherosclerosis was not higher in women with TS compared with controls (median and interquartile range 0 [0–92] in TS vs. 0 [0–81]mm3 in controls, p = 0.29). Among women with TS, women with subclinical CAD were older (46 ± 13 vs. 37 ± 11 years, p < 0.001), had higher blood pressure (systolic blood pressure 129 ± 16 vs. 121 ± 16 mmHg, p < 0.05) and were more frequently diagnosed with type 2 diabetes (5 [13%] vs. 2 [3%], p < 0.05). Karyotype or congenital heart defects were not associated with subclinical CAD. Some women with TS show early signs of CAD, however overall, not more than women without TS. Conventional cardiovascular risk factors were the principal determinants of CAD also in TS, and CAD prevention strategies should be observed. ClinicalTrial.gov Identifier: NCT01678261 (https://clinicaltrials.gov/ct2/show/NCT01678261).
Bibliographical noteFunding Information:
Anthonie Duijnhouwer, Lidia Bons and Jolien Roos-Hesselink received a grant from the Netherlands Heart Foundation (Grant number NHS 2013T093). Claus H. Gravholt received grants from the Novo Nordisk Foundation (Grant agreement NNF13OC0003234 and NNF15OC0016474). Acknowledgements
Claus H. Gravholt is a member of the European Reference Network on Rare Endocrine Conditions (ENDO-ERN), Project ID number 739543.
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