CONTEXT: Dehydroepiandrosterone sulfate (DHEA-S), a major circulating sex steroid prohormone, declines with age. Low levels have been associated with increased cardiovascular disease (CVD) risk and all-cause mortality, although these results have not been consistently replicated, particularly in women. OBJECTIVE: Our objective was to examine the association of circulating DHEA-S levels, CVD, and mortality risk among postmenopausal women with suspected myocardial ischemia. DESIGN: In the Women's Ischemia Syndrome Evaluation, 270 postmenopausal women underwent coronary angiography and blood hormone levels for suspected ischemia and were followed annually. The primary outcome of interest was CVD mortality; secondary analyses included all-cause mortality and nonfatal CVD events (myocardial infarction, stroke, and congestive heart failure) and angiographic obstructive coronary artery disease (CAD). RESULTS: Women in the lowest DHEA-S tertile had higher CVD mortality (17% 6-yr mortality rate vs. 8%; log-rank P = 0.011), and all-cause mortality (21 vs. 10%; P = 0.011) compared with women with higher DHEA-S levels. The increased CVD mortality risk [hazard ratio (HR) = 2.55; 95% confidence interval (CI) = 1.19-5.45] remained unchanged after adjustment for multiple CVD risk factors (HR = 2.43; 95% CI = 1.06-5.56) but became nonsignificant when further adjusting for the presence or severity of angiographic obstructive CAD (HR = 1.99; 95% CI = 0.87-4.59). Results were similar for all-cause mortality. Lower DHEA-S levels were only marginally but not independently associated with obstructive CAD. CONCLUSIONS: Among postmenopausal women with coronary risk factors undergoing coronary angiography for suspected myocardial ischemia, lower DHEA-S levels were linked with higher CVD mortality and all-cause mortality. Our study provides valuable feasibility data useful for future investigations and possible mechanistic pathways.
CONTEXT: Dehydroepiandrosterone sulfate (DHEA-S), a major circulating sex steroid prohormone, declines with age. Low levels have been associated with increased cardiovascular disease (CVD) risk and all-cause mortality, although these results have not been consistently replicated, particularly in women. OBJECTIVE: Our objective was to examine the association of circulating DHEA-S levels, CVD, and mortality risk among postmenopausal women with suspected myocardial ischemia. DESIGN: In the Women's Ischemia Syndrome Evaluation, 270 postmenopausal women underwent coronary angiography and blood hormone levels for suspected ischemia and were followed annually. The primary outcome of interest was CVD mortality; secondary analyses included all-cause mortality and nonfatal CVD events (myocardial infarction, stroke, and congestive heart failure) and angiographic obstructive coronary artery disease (CAD). RESULTS:Women in the lowest DHEA-S tertile had higher CVD mortality (17% 6-yr mortality rate vs. 8%; log-rank P = 0.011), and all-cause mortality (21 vs. 10%; P = 0.011) compared with women with higher DHEA-S levels. The increased CVD mortality risk [hazard ratio (HR) = 2.55; 95% confidence interval (CI) = 1.19-5.45] remained unchanged after adjustment for multiple CVD risk factors (HR = 2.43; 95% CI = 1.06-5.56) but became nonsignificant when further adjusting for the presence or severity of angiographic obstructive CAD (HR = 1.99; 95% CI = 0.87-4.59). Results were similar for all-cause mortality. Lower DHEA-S levels were only marginally but not independently associated with obstructive CAD. CONCLUSIONS: Among postmenopausal women with coronary risk factors undergoing coronary angiography for suspected myocardial ischemia, lower DHEA-S levels were linked with higher CVD mortality and all-cause mortality. Our study provides valuable feasibility data useful for future investigations and possible mechanistic pathways.
Authors: Frank Z Stanczyk; Cristin C Slater; Diana E Ramos; Colleen Azen; Ganesh Cherala; Charles Hakala; Guy Abraham; Subir Roy Journal: Menopause Date: 2009 Mar-Apr Impact factor: 2.953
Authors: Sherita Hill Golden; Ann Maguire; Jingzhong Ding; J R Crouse; Jane A Cauley; Howard Zacur; Moyses Szklo Journal: Am J Epidemiol Date: 2002-03-01 Impact factor: 4.897
Authors: Di Zhao; Eliseo Guallar; Pamela Ouyang; Vinita Subramanya; Dhananjay Vaidya; Chiadi E Ndumele; Joao A Lima; Matthew A Allison; Sanjiv J Shah; Alain G Bertoni; Matthew J Budoff; Wendy S Post; Erin D Michos Journal: J Am Coll Cardiol Date: 2018-06-05 Impact factor: 24.094
Authors: Krzysztof Rutkowski; Paweł Sowa; Joanna Rutkowska-Talipska; Anna Kuryliszyn-Moskal; Ryszard Rutkowski Journal: Drugs Date: 2014-07 Impact factor: 9.546
Authors: L B Harrington; B T Marck; K L Wiggins; B McKnight; S R Heckbert; N F Woods; A Z LaCroix; M Blondon; B M Psaty; F R Rosendaal; A M Matsumoto; N L Smith Journal: J Thromb Haemost Date: 2017-01-08 Impact factor: 5.824
Authors: Monik C Jiménez; Qi Sun; Markus Schürks; Stephanie Chiuve; Frank B Hu; Joann E Manson; Kathryn M Rexrode Journal: Stroke Date: 2013-05-23 Impact factor: 7.914
Authors: Olivia R Orta; Tianyi Huang; Laura D Kubzansky; Kathryn L Terry; Brent A Coull; Michelle A Williams; Shelley S Tworoger Journal: Psychoneuroendocrinology Date: 2019-11-14 Impact factor: 4.905