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Deficiencies in circulating testosterone and dehydroepiandrosterone sulphate, and depression in men with systolic chronic heart failure
Author(s) -
Jankowska Ewa A.,
Drohomirecka Anna,
Ponikowska Beata,
Witkowska Agnieszka,
Lopuszanska Monika,
Szklarska Alicja,
BorodulinNadzieja Ludmila,
Banasiak Waldemar,
PooleWilson Philip A.,
Ponikowski Piotr
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq108
Subject(s) - medicine , depression (economics) , androgen , heart failure , dehydroepiandrosterone , testosterone (patch) , beck depression inventory , androgen deficiency , endocrinology , dehydroepiandrosterone sulfate , hormone , anxiety , psychiatry , economics , macroeconomics
Aims Elderly men with androgen deficiencies are prone to develop late‐onset depression. We investigated links between circulating androgens and depression, and their combined impact on outcome in men with chronic heart failure (CHF). Methods and results Serum total testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) were measured using immunoassays in 163 men with stable systolic CHF [age: 60 ± 10 years, NYHA class (I/II/III/IV): 27/84/46/6] and 316 healthy men. Depression was assessed using Beck Depression Inventory (BDI) and defined as BDI ≥16 points. In men with CHF, reduced TT and DHEAS, advanced NYHA class, elevated N‐terminal pro‐B type natriuretic peptide (NT‐proBNP), reduced glomerular filtration rate, and reduced haemoglobin independently predicted severity of depressive symptoms (all P < 0.05). Depression was present in 20, 37 and 77% of men with no androgen deficiency, either TT or DHEAS deficiency, and both androgen deficiencies, respectively ( P < 0.0001). During follow‐up (median: 28 months), there were 87 (53%) cardiovascular deaths or unplanned hospitalizations. TT and DHEAS deficiencies (defined as ≤ the 10th percentile of serum androgen levels in healthy controls) and BDI ≥16 points independently predicted unfavourable outcome (all P < 0.05). Conclusion TT and DHEAS deficiencies predict severity of depression in men with CHF. Depression and combined androgen deficiencies are independently related to poor outcome in these patients.