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Assessment of testosterone /estradiol ratio , DHEA-S level and correlation with coronary inflammatory markers IL-1 & 6 , TNF-1 and hsCRP predict 5 years risk of cardiovascular disease in men.

Session Poster Session 7

Speaker Naresh Sen

Event : ESC Congress 2019

  • Topic : basic science
  • Sub-topic : Basic Science - Cardiac Diseases: Leukocytes, Inflammation, Immunity
  • Session type : Poster Session

Authors : N Sen (Jaipur,IN), SONAL Tanwar (Jaipur,IN), ASHOK Jain (Jaipur,IN), J Sharma (Jaipur,IN), RK Gokhroo (Ajmer,IN), ASHWIN Mehta (Mumbai,IN), BALBIR Kalra (gurgaon,IN)

N. Sen1 , S. Tanwar1 , A. Jain2 , J. Sharma1 , R.K. Gokhroo3 , A. Mehta4 , B. Kalra5 , 1HG SMS Hospital - Jaipur - India , 2Narayana Hrudayalaya, Cardiology - Jaipur - India , 3J L N Medical College, Cardiology - Ajmer - India , 4Kokilaben Dhirubhai Ambani Hospital - Mumbai - India , 5Artemis Hospital, Cardiology - gurgaon - India ,

European Heart Journal ( 2019 ) 40 ( Supplement ), 3897

Background: Previous data showed the adrenal sex hormone dehydroepiandrosterone (DHEA) which is present in serum mainly as the sulfate DHEA-S is the most abundant steroid hormone and another hormones like testosterone, estradiol are related to cardiovascular risk in men. Literatures revealed vascular and metabolic actions of DHEA/-S, evidence for an association between DHEA/-S levels and cardiovascular events is controversy.

Objectives: Our aim is to review and clear the contradictory point regarding cardiovascular risk and correlation of testeosterone/ estradiol ratio, DHEA-S level with coronary inflammatory markers in men.

Methods: Large population based cohort study done at multi centre of cardiology from 2013- 2018 in India. We enrolled total 23631 normal healthy male population age between 40 to 60 years and divided into two groups based on testosterone/estradiol ratio (Group A (n=2450) lower value of T/E ratio and Group B (n=21181) normal or higher T/E ratio. We did cohort analysis for 5 years and evaluated DHEA-S level and correlated it with coronary inflammatory markers and cardiovascular risk.

Results: In group A (low T/E ratio) we found low level of DHEA-S (98% of individual) and higher value of interleukins IL-1 (68%),IL-6 (74%) and tumor necrosis factor TNF-1 (71%) and high sensitive C-reactive protein (hsCRP) (73% of individual). Data revealed two fold increase of high blood pressure and LDL cholesterol level as compared to group B (normal or high T/E ratio and normal or high value of DHEA-S). 2.5 fold higher rate of coronary heart disease (CHD) found in group A versus in group B. We did not found as much significant difference in stroke, carotid and peripheral artery disease. T/E ratio and DHEA-S levels were inversely associated with the age-adjusted risk of a CHD event; the hazard ratios and 95% confidence intervals per standard deviation (SD) increase were 0.76 (0.66 to 0.91) and 0.82 (0.72 to 0.93), respectively.

Conclusions: Decrease ratio of testosterone/estradiol levels correlate decreased levels of DHEA-S which may increase the risk of CHD in men. For future aspect, correction of T/E ratio, DHEA-S and increase its awareness should be at mass level for prevention of CHD.

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