{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:39:03Z","timestamp":1794004743301,"version":"4.8.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"15","license":[{"start":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T00:00:00Z","timestamp":1656720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Swedish Research Council for Health, Working Life and Welfare","doi-asserted-by":"crossref","award":["2021-01968"],"award-info":[{"award-number":["2021-01968"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We compared the incidence of cardiovascular disease (CVD) in transgender participants with a diagnosis of gender dysphoria (GD) with and without gender-affirming hormone therapy (GAHT) to the incidence observed in the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The population-based cohort included all individuals &amp;gt;10 years in Sweden linked to Swedish nationwide healthcare Registers (2006\u201316). Two comparator groups without GD\/GAHT were matched (1:10) on age, county of residence, and on male and female birth-assigned sex, respectively. Cox proportional models provided hazard ratios (HRs) and 95% confidence intervals (CI) for CVD outcomes. Among 1779 transgender individuals [48% birth-assigned males (AMAB), 52% birth-assigned females (AFAB)], 18 developed CVD, most of which were conduction disorders. The incidence of CVD for AFAB individuals with GD was 3.7 per 1000 person-years (95% CI: 1.4\u201310.0). Assigned male at birth individuals with GD had an incidence of CVD event of 7.1 per 1000 person-years (95% CI: 4.2\u201312.0). The risk of CVD event was 2.4 times higher in AMAB individuals (HR: 2.4, 95% CI: 1.3\u20134.2) compared with cisgender women, and 1.7 higher compared with cisgender men (HR: 1.7, 95% CI: 1.0\u20132.9). Analysis limited to transgender individuals without GAHT yielded similar results to those with GAHT treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of CVD among GD\/GAHT individuals was low, although increased compared with matched individuals without GD and similar to the incidence among GD\/no GAHT individuals, thus not lending support for a causal relationship between treatment and CVD outcomes. Larger studies with longer follow-up are needed to verify these findings, as well as possible effect modification by comorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwac133","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T01:16:26Z","timestamp":1656724586000},"page":"2017-2026","source":"Crossref","is-referenced-by-count":46,"title":["Cardiovascular outcomes in transgender individuals in Sweden after initiation of gender-affirming hormone therapy"],"prefix":"10.1093","volume":"29","author":[{"given":"Maria A","family":"Karalexi","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University , 753 09 Uppsala , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Frisell","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet , 171 77 Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Cnattingius","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet , 171 77 Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital , 171 76 Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Holmberg","sequence":"additional","affiliation":[{"name":"ANOVA, Andrology, Sexual Medicine and Transgender Medicine, Karolinska University Hospital , 171 76 Stockholm , Sweden"},{"name":"Department of Medicine, Huddinge, Karolinska Institutet , 171 77 Stockholm , 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