Rojas, Lyda Z; Gómez-Ochoa, Sergio Alejandro; Echeverría, Luis E; Bautista-Niño, Paula Katherine; Hunziker, Lukas; Eisenga, Michele F; Muka, Taulant (2022). Circulating DHEA-S levels and major cardiovascular outcomes in chronic Chagas cardiomyopathy: A prospective cohort study. International journal of cardiology, 349, pp. 90-95. Elsevier 10.1016/j.ijcard.2021.11.054
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OBJECTIVE
To analyze the association of circulating dehydroepiandrosterone sulfate (DHEA-S) levels with cardiovascular outcomes in patients with chronic Chagas cardiomyopathy (CCM) diagnosis.
BACKGROUND
DHEA-S is among the main endogenous steroid hormones. Some studies have suggested a relevant role of this hormone in infections and the setting of CCM. Nevertheless, no study has evaluated the prognostic role of DHEA-S in CCM patients.
METHODS
Prospective cohort study. Patients with CCM and reduced ejection fraction were included. We explored the association of DHEA-S levels with NT-proBNP levels and echocardiographic variables using linear regression models. Next, by using Cox Proportional Hazard models, we examined whether levels of DHEA-S could predict a composite outcome (CO) including all-cause mortality, cardiac transplantation, and implantation of a left ventricular assist device (LVAD).
RESULTS
Seventy-four patients were included (59% males, median age: 64 years). After adjustment for confounding factors, high DHEA-S levels were associated with better LVEF, lower left atrium volume, end-systolic volume of the left ventricle and lower NT-proBNP levels. 43% of patients experienced the CO during a median follow-up of 40 months. Increased levels of DHEA-S were associated with a lower risk of developing the CO (HR 0.43; 95%CI 0.21-0.86). Finally, adding DHEA-S to the multivariate model did not improve the prediction of the CO, but substituting NT-proBNP in the model with DHEA-S showed similar performance.
CONCLUSIONS
In patients with CCM, higher DHEA-S levels were associated with lower mortality, heart transplantation, and LVAD implantation. Further larger studies are required to confirm our results and assess causality.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Hunziker Munsch, Lukas Christoph, Muka, Taulant |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
0167-5273 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Andrea Flükiger-Flückiger |
Date Deposited: |
09 Dec 2021 12:10 |
Last Modified: |
27 Dec 2022 11:20 |
Publisher DOI: |
10.1016/j.ijcard.2021.11.054 |
PubMed ID: |
34838827 |
Uncontrolled Keywords: |
Chagas cardiomyopathy Chagas disease DHEA-S Heart transplantation Heart-assist devices Mortality |
BORIS DOI: |
10.48350/161714 |
URI: |
https://boris.unibe.ch/id/eprint/161714 |
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