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Circulating DHEA-S levels and major cardiovascular outcomes in chronic Chagas cardiomyopathy: A prospective cohort study

Abstract: 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.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: International Journal of Cardiology Volume 349, 15 February 2022, Pages 90-95

Editorial: Elsevier

 Fecha de publicación: 15/02/2022

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ijcard.2021.11.054

ISSN: 0167-5273,1874-1754

Url de la publicación: https://doi.org/10.1016/j.ijcard.2021.11.054

Autoría

ROJAS, LYDA Z.

GÓMEZ-OCHOA, SERGIO ALEJANDRO

ECHEVARRÍA, LUIS E.

BAUTISTA-NIÑO, PAULA KATHERINE

HUNZIKER, LUKAS

EISENGA, MICHELE F.

MUKA, TAULANT