Table 1.

Sex differences in key established cardiovascular biomarkers of myocardial injury/stretch, inflammation, adipose, and fibrosis pathways

	Biomarkers	Source of sex differences	Circulating levels	Effect of sex on biomarker-CVD association
Myocardial injury/stretch	Natriuretic peptides	● Sex hormones: E2 ↑ NP, T ↓ NP ● Gynoid fat deposits correlated with ↑ NP	General population: women > men HF: women = men	Prediction of incident HF: mixed Prognostic value: limited data
	Cardiac troponins	● Greater heart size and cardiomyocyte volume in men ● Sex hormones: T induces/E2 suppresses cardiomyocyte hypertrophy/apoptosis ● Higher prevalence of obstructive CAD in men	General population: men > women CAD, ACS, and HF: men > women	Prediction of CV events: mixed Prognostic value: mixed
Inflammation	C-reactive protein	● Many immune-response related genes are X-linked ● Mixed data on sex hormones and adipose tissue	General population: women > men MetS, stable angina, MI: women > men	No influence of sex on predictive or prognostic abilities
Adipose Tissue Metabolism	Leptin	● Greater percentage of body fat in women	General population: women > men	Leptin sensitivity may be greater in women > men
	Adiponectin (Total and HMW)	● More subcutaneous fat in women	General population: women > men	Unknown
Fibrosis	Galectin-3	● Greater adipose tissue mass in women	General population: women > men HF: mixed	Prediction of incident HF: mixed Prognostic value: unknown
	Soluble ST2	● Unknown, potential role of sex hormones and obesity	General population: men > women HF: men > women	Unknown

Abbreviations: ACS = acute coronary syndrome, CAD = coronary artery disease, E2 = estradiol, HF = heart failure, MetS = metabolic syndrome, MI = myocardial infarction, NP = natriuretic peptide, T = testosterone.