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    Poster Networking

    Women’s Health

    Poster Networking Session

    PB1504 - Hormone use and cardiovascular thromboembolic risk among transgender women

    Tuesday, June 27, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Presenting Author(s)

    • EG

      Eduarda Grinsztejn, MD

      Hematology Oncology fellow
      Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
      Cleveland, Ohio, United States

      • Co-Author(s)

    • CC

      Carolina Coutinho

      PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • EP

      Eduardo Peixoto

      MPH
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • GA

      Guilherme Amaral Calvet

      MD, PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • JB

      Joanna Bokel

      MD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      rio de janeiro, Rio de Janeiro, Brazil

    • DP

      Daniela P. Mendes-de-Almeida

      MD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • MD

      Monica Derrico

      BSc
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • EJ

      Emilia Jalil

      MD, PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • LV

      Luciane Velasque

      PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • BG

      Beatriz Grinsztejn

      MD, PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    • Evi X. Stavrou, MD

      Associate Professor
      Department of Medicine, Hematology and Oncology Division, CWRU School of Medicine, Cleveland, OH, USA.
      Cleveland, Ohio, United States

    • RM

      Rodrigo Moreira

      MD, PhD
      Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
      Rio de Janeiro, Rio de Janeiro, Brazil

    Background: Gender-affirming hormone therapy is an integral part of caring for transgender individuals. Although estrogen therapy has been linked to increased rates of cardiovascular thromboembolic events (CTE) in premenopausal cisgender women, its impact on CTE risk among the transgender population has not been vastly examined.

    Aims: To define the prevalence and risk factors of CTE among transgender women (TGW) on feminization treatment.

    Methods: A retrospective cohort study was conducted at Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ, Brazil from 2015-2022. Eligible participants were adults that self-identified as TGW. CTEs were defined as deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI), and cerebrovascular accident (CVA). Covariables are described in Table 1. Variables that achieved p< 0.2 in the univariate analysis were included in the multivariate model. Estrogen use was explored in two categories: hormone use at any stage and length of use.

    Results: 748 participants were included in the study. Median age was 30 years, median follow-up ranged from 355.37-935.29 person/years. There were 21 CTE (9 CVAs, 7 DVTs, 3 MIs and 2 PEs) in 19 participants with an overall prevalence of 2.54%. All thrombotic events occurred in participants with reported estrogen use. In the univariate analysis, DM, HTN, CVD, age and DLD were significantly associated with a higher risk for CTE (Table 1). In the multivariate analysis, no significant association between estrogen use and CTE was observed, regardless of categorization (Figures 2A/2B). However, individuals who used estrogen at any point had 69% higher risk for CTE (OR1.69;CI95% 0.3-32.39).

    Conclusion(s): Estrogen use in this transgender cohort was frequent, and although not significantly associated with CTE, a trend towards higher risk was observed. Even in young transgender women, addressing modifiable cardiovascular risk factors should be a critical priority. Prospective studies are needed to better understand the intrinsic risks of this population and risk reduction strategies.