title: Dehydroepiandrosterone and cardiac allograft vasculopathy.
abstract: 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.
authors.affiliation: Division of Cardiology, The Bowman Gray School of Medicine, Winston-Salem, NC 27157-1045, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Herrington
authors.forename: N
authors.initials: N
authors.lastname: Nanjee
authors.forename: S C
authors.initials: SC
authors.lastname: Achuff
authors.forename: D E
authors.initials: DE
authors.lastname: Cameron
authors.forename: B
authors.initials: B
authors.lastname: Dobbs
authors.forename: K L
authors.initials: KL
authors.lastname: Baughman
mesh_terms: 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
chemical_list: D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate