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Serum Androgens and Risk of Atrial Fibrillation in Older Men: The Cardiovascular Health Study.
Tuesday,2018-05-01 17:34 America/Los_Angeles — ecterry
| Title | Serum Androgens and Risk of Atrial Fibrillation in Older Men: The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2018 |
| Authors | Rosenberg, MA, Shores, MM, Matsumoto, AM, Bůzková, P, Lange, LA, Kronmal, RA, Heckbert, SR, Mukamal, KJ |
| Journal | Clin Cardiol |
| Date Published | 2018 Apr 19 |
| ISSN | 1932-8737 |
| Abstract | <p><b>BACKGROUND: </b>Decline in serum androgens is common among older men and has been associated with cardiovascular disease, although its role in risk of atrial fibrillation (AF) has not been well defined.</p><p><b>HYPOTHESIS: </b>Low serum androgens are associated with an increased risk of AF.</p><p><b>METHODS: </b>We examined the prospective associations between testosterone, its more active metabolite dihydrotestosterone (DHT), and sex-hormone binding globulin (SHBG) with risk of AF among 1019 otherwise healthy men of average age 76.3±4.9 years in the Cardiovascular Health Study.</p><p><b>RESULTS: </b>After median follow-up of 9.5 years, 304 (30%) men developed AF. We detected a nonlinear association with risk of incident AF in both free and total DHT, in which subjects with the lowest levels had a higher risk of incident AF. After adjustment for demographics, clinical risk factors, left atrial diameter, and serum NT-proBNP levels, men with free DHT less than 0.16 ng/dL were at increased risk compared with men with higher levels (HR 1.48, CI 1.01-2.17, p<0.05). Sensitivity analyses confirmed that the increased risk was not cutpoint-specific, with a significant association noted up to cutpoints less than ~0.2 ng/dL. We also detected a complex nonlinear association between SHBG and incident AF, in which subjects in the middle quintile (52.9 - 65.3 nmol/L) had increased risk.</p><p><b>CONCLUSION: </b>Among older men, low free DHT is associated with an increased risk of incident atrial fibrillation. Further studies are needed to explore mechanisms for this association.</p> |
| DOI | 10.1002/clc.22965 |
| Alternate Journal | Clin Cardiol |
| PubMed ID | 29671886 |
ePub date:
18/04