Dehydroepiandrosterone and cardiac allograft vasculopathy.
BACKGROUND
Tissue culture, animal model, and epidemiologic studies suggest that dehydroepiandrosterone may inhibit atherosclerosis through its potent antiproliferative effects. Because cardiac allograft vasculopathy is predominantly a proliferative abnormality of intimal and medial smooth muscle cells, plasma levels of dehydroepiandrosterone may play an important role in the development of this disease.


METHODS
Sixty-one cardiac allograft recipients who survived for 1 year or more and had at least one annual follow-up cardiac catheterization were included in the study. Plasma levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate, and free dehydroepiandrosterone (dehydroepiandrosterone not bound to sex hormone-binding globulin) were measured in all 61 subjects and compared with the presence or absence of cardiac allograft vasculopathy as defined by angiography.


RESULTS
Plasma levels of total and free dehydroepiandrosterone were lower in subjects in whom cardiac allograft vasculopathy developed (p = 0.005 and 0.003, respectively). Furthermore, the time to development of cardiac allograft vasculopathy was shorter in subjects with low levels of total and free dehydroepiandrosterone (p = 0.062 and 0.046, respectively). This relationship was maintained after adjusting for age, gender, cholesterol, prednisone use, and blood pressure.


CONCLUSIONS
Low plasma levels of dehydroepiandrosterone may facilitate and high levels may retard the development of cardiac allograft vasculopathy.
Herrington
D M
DM
Division of Cardiology, The Bowman Gray School of Medicine, Winston-Salem, NC 27157-1045, USA.
Nanjee
N
N
Achuff
S C
SC
Cameron
D E
DE
Dobbs
B
B
Baughman
K L
KL
D000328:Adult; D017023:Coronary Angiography; D003687:Dehydroepiandrosterone / Q000097:blood*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000401:mortality / Q000502:physiology* / Q000706:statistics & numerical data; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous
D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate