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Shufelt C, Bretsky P, Almeida CM, et al. DHEA-S levels and cardiovascular disease mortality in postmenopausal women: results from the National Institutes of Health--National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE). J Clin Endocrinol Metab. 2010;95(11):4985-92doi: 10.1210/jc.2010-0143.
Shufelt, C., Bretsky, P., Almeida, C. M., Johnson, B. D., Shaw, L. J., Azziz, R., Braunstein, G. D., Pepine, C. J., Bittner, V., Vido, D. A., Stanczyk, F. Z., & Bairey Merz, C. N. (2010). DHEA-S levels and cardiovascular disease mortality in postmenopausal women: results from the National Institutes of Health--National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE). The Journal of clinical endocrinology and metabolism, 95(11), 4985-92. https://doi.org/10.1210/jc.2010-0143
Shufelt, Chrisandra, et al. "DHEA-S levels and cardiovascular disease mortality in postmenopausal women: results from the National Institutes of Health--National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE)." The Journal of clinical endocrinology and metabolism vol. 95,11 (2010): 4985-92. doi: https://doi.org/10.1210/jc.2010-0143
Shufelt C, Bretsky P, Almeida CM, Johnson BD, Shaw LJ, Azziz R, Braunstein GD, Pepine CJ, Bittner V, Vido DA, Stanczyk FZ, Bairey Merz CN. DHEA-S levels and cardiovascular disease mortality in postmenopausal women: results from the National Institutes of Health--National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE). J Clin Endocrinol Metab. 2010 Nov;95(11):4985-92. doi: 10.1210/jc.2010-0143. Epub 2010 Aug 25. PMID: 20739385; PMCID: PMC2968728.
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J Clin Endocrinol Metab. 2010 Nov;95(11):4985-92. doi: 10.1210/jc.2010-0143. Epub 2010 Aug 25.

DHEA-S levels and cardiovascular disease mortality in postmenopausal women: results from the National Institutes of Health--National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE).

The Journal of clinical endocrinology and metabolism

Chrisandra Shufelt, Philip Bretsky, Cristina M Almeida, B Delia Johnson, Leslee J Shaw, Ricardo Azziz, Glenn D Braunstein, Carl J Pepine, Vera Bittner, Diane A Vido, Frank Z Stanczyk, C Noel Bairey Merz

Affiliations

  1. Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.

PMID: 20739385 PMCID: PMC2968728 DOI: 10.1210/jc.2010-0143

Abstract

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.

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