Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men.
Eur Heart J
; 36(40): 2706-15, 2015 Oct 21.
Article
en En
| MEDLINE
| ID: mdl-26248567
ABSTRACT
AIMS:
There is a significant uncertainty regarding the effect of testosterone replacement therapy (TRT) on cardiovascular (CV) outcomes including myocardial infarction (MI) and stroke. The aim of this study was to examine the relationship between normalization of total testosterone (TT) after TRT and CV events as well as all-cause mortality in patients without previous history of MI and stroke. METHODS ANDRESULTS:
We retrospectively examined 83 010 male veterans with documented low TT levels. The subjects were categorized into (Gp1 TRT with resulting normalization of TT levels), (Gp2 TRT without normalization of TT levels) and (Gp3 Did not receive TRT). By utilizing propensity score-weighted Cox proportional hazard models, the association of TRT with all-cause mortality, MI, stroke, and a composite endpoint was compared between these groups. The all-cause mortality [hazard ratio (HR) 0.44, confidence interval (CI) 0.42-0.46], risk of MI (HR 0.76, CI 0.63-0.93), and stroke (HR 0.64, CI 0.43-0.96) were significantly lower in Gp1 (n = 43 931, median age = 66 years, mean follow-up = 6.2 years) vs. Gp3 (n = 13 378, median age = 66 years, mean follow-up = 4.7 years) in propensity-matched cohort. Similarly, the all-cause mortality (HR 0.53, CI 0.50-0.55), risk of MI (HR 0.82, CI 0.71-0.95), and stroke (HR 0.70, CI 0.51-0.96) were significantly lower in Gp1 vs. Gp2 (n = 25 701, median age = 66 years, mean follow-up = 4.6 years). There was no difference in MI or stroke risk between Gp2 and Gp3.CONCLUSION:
In this large observational cohort with extended follow-up, normalization of TT levels after TRT was associated with a significant reduction in all-cause mortality, MI, and stroke.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Testosterona
/
Infarto del Miocardio
Tipo de estudio:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Eur Heart J
Año:
2015
Tipo del documento:
Article
País de afiliación:
Estados Unidos