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Estrogen Has Anti-Ischemic
Effect in Men, Too

By Bruce Jancin
Family Practice News

--Contributed by Trish


MINNEAPOLIS

High-dose estrogen has an acute beneficial effect upon myocardial ischemia in men with coronary disease.

Thus, the cardiovascular benefits of estrogen are not gender specific, Dr. Susan R. Davis declared at the annual meeting of the Endocrine Society.

She reported on 12 men with established coronary disease and consistently abnormal exercise treadmill tests who received 25 mg of IV Premarin on one occasion 2 hours prior to stress testing and a matching volume of saline prior to another treadmill test. All antianginal drugs were stopped 48 hours beforehand in this randomized, double-blind study.

Pretreatment with Premarin resulted in a significant increase in total exercise time and in exercise duration required to elicit a 1-mm ST-segment depression.

Given the likelihood of a carryover effect from the patients' recently halted beta blockers and calcium channel blockers, this study probably underestimates the true acute benefit.

Further study of estrogen and agents with estrogenlike effects upon coronary artery vasomotor function is warranted in men, concluded Dr. Davis, of the Jean Hailes' Foundation in Clayton, Australia.

Also under study is the use of insulin-like growth factor-1 (IGF-1 in patients with congestive heart failure.

Dr. Marc Y. Donath reported that acute administration of IGF-1 in eight congestive heart failure patients improved cardiac function by afterload reduction and possibly through a positive inotropic effect.

In this randomized, double-blind crossover trial, IGF-1 was associated with a 27% rise in cardiac indes, a 21% boost in stroke volume index, a 28% reduction in systemic vascular resistance, a 25% decline in pulmonary artery wedge pressure, and a 33% drop in right atrial pressure, compared with placebo during 7 hours of continuous monitoring, said Dr. Donath, of University Hospital, Zurich,"