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Extreme Estradiol Levels Raise Heart Failure Death Risk

Last Updated: May 12, 2009.

Men with heart failure and moderate levels of serum estradiol are at lower risk of death than their counterparts with particularly high and low levels of the hormone, according to a study in the May 13 issue of the Journal of the American Medical Association.

TUESDAY, May 12 (HealthDay News) -- Men with heart failure and moderate levels of serum estradiol are at lower risk of death than their counterparts with particularly high and low levels of the hormone, according to a study in the May 13 issue of the Journal of the American Medical Association.

Ewa A. Jankowska, M.D., of the Military Hospital in Wroclaw, Poland, and colleagues conducted a study of 501 men with a mean age of 58 and chronic heart failure. The men had a left ventricular ejection fraction of 28 percent, and while 52 had a New York Heart Association (NYHA) class of 1, the class was 2 for 231 patients, 3 for 181 patients, and 4 for 37 patients. During three years of follow-up, there were 171 deaths (34 percent of the cohort).

Men in quintile 3 of serum concentrations of estradiol had the lowest rate of heart failure compared to those in the lowest and highest quintiles, the researchers found. Patients in quintile 1 had increased serum total testosterone, decreased serum DHEA-S, advanced NYHA class, decreased total fat tissue mass and impaired renal function, while their counterparts in quintile 5 had increased serum bilirubin and liver enzymes, and decreased serum levels of sodium, the investigators noted.

"For increasing estradiol quintiles, three-year survival rates adjusted for clinical variables and androgens were 44.6 percent, 65.8 percent, 82.4 percent, 79.0 percent, and 63.6 percent, respectively," the authors write, while further concluding, "high and low concentrations of estradiol compared with the middle quintile of estradiol are related to an increased mortality."

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