The cardiac biomarkers hs-cTn and NT-proBNP are released into the bloodstream when the heart has been damaged. Cisgender males tend to have a higher natural concentration of hs-cTn than cisgender females,³ and cisgender females tend to have a higher natural concentration of NT-proBNP than cisgender males.⁴

Because there is an absence of medical literature that studies and defines cardiac biomarkers in transgender individuals, the team of researchers conducted a study to understand how hs-cTn and NT-proBNP concentrations differ between healthy cisgender individuals and healthy transgender individuals.

The study measured the cardiac biomarkers in 79 transgender men and 93 transgender women who had been prescribed testosterone or estrogen for more than one year. The researchers discovered the differences in cardiac biomarkers were similar to what is seen in cisgender men and women.

Results showed that transgender men have higher hs-cTn concentrations than transgender women, like cisgender individuals. Transgender women had higher NT-proBNP concentrations than men, like cisgender individuals. The study shows that "sex hormones, rather than sex assigned at birth, may be a stronger driver of the observed concentration differences between healthy men and women for biomarkers of cardiac disease," the researchers wrote.

"This study hopefully jumpstarts additional research that will shed even more light on how sex hormones and gender-affirming therapy affect different biomarkers in transgender individuals," Carterson said. "Abbott is committed to diversity and health equity to make sure that all patients are getting the care that they need by empowering their care providers with accurate diagnostic information about their health."

The study, "Distribution of High-Sensitivity Cardiac Troponin and N-Terminal Pro–Brain Natriuretic Peptide in Healthy Transgender People" was published in JAMA Cardiology in the fall.

The researchers said additional studies are needed in the transgender population to quantify any potential cardiac consequences of gender-affirming therapy and to optimize cardiac health in the transgender community.

References

¹Kimenai DM, Janssen EBNJ, Eggers KM, et al. Sex-specific vs overall clinical decision limits for cardiac troponin I and T for the diagnosis of acute myocardial infarction: a systematic review. Clin Chem. 2018;64(7):1034-1043. doi:10.1373/clinchem.2018. 286781
²Saenger AK, Dalenberg DA, Bryant SC, Grebe SK, Jaffe AS. Pediatric brain natriuretic peptide concentrations vary with age and sex and appear to be modulated by testosterone. Clin Chem. 2009; 55(10):1869-1875. doi:10.1373/clinchem.2009.123778
³Kimenai DM, Janssen EBNJ, Eggers KM, et al. Sex-specific vs overall clinical decision limits for cardiac troponin I and T for the diagnosis of acute myocardial infarction: a systematic review. Clin Chem. 2018;64(7):1034-1043. doi:10.1373/clinchem.2018. 286781
⁴Saenger AK, Dalenberg DA, Bryant SC, Grebe SK, Jaffe AS. Pediatric brain natriuretic peptide concentrations vary with age and sex and appear to be modulated by testosterone. Clin Chem. 2009; 55(10):1869-1875. doi:10.1373/clinchem.2009.123778