Association Between ESR2 Genetic Variants and Risk of Myocardial Infarction (Lipids, Lipoproteins, And Cardiovascular Risk Factors) (Clinical Report‪)‬

Myocardial infarction (MI) [4] and related atherosclerotic cardiovascular disease (CVD) are the leading cause of death in men and women, although women develop CVD approximately 10 years later than men (1). Multiple environmental and genetic factors contribute to the development of these complex diseases. The genes coding for the estrogen receptors (ERs), which belong to the nuclear receptor gene family of transcription factors, are ideal candidates to explain the sex differences observed. Extensive studies of the role of the ER[alpha] and ER[beta] receptors in cardiovascular disease have shown that both receptors are expressed in humans in vascular endothelial, smooth muscle, and myocardial cells (2). ER[beta] is expressed more highly in vascular smooth muscle cells in women than men, whereas ER[alpha] is present in equal quantities (3 ). In the human heart, ER[beta] is up-regulated by pressure overload, and ER[beta] mRNA levels have been observed to be increased in hearts of patients with aortic stenosis, with the greatest increases seen in women (4 ). ER[alpha] has also been associated with the development of coronary artery disease in women (5).