A recent study revealed that testosterone therapy in men who underwent coronary angiography could increase the risk of heart attack, ischemic stroke and death. The study has appeared in the November 6 issue of JAMA.
It has been known that testosterone therapy improves testosterone levels, sexual function, bone mineral density and so on, however, a recent randomized clinical trial raised concerns since it was stopped due to adverse cardiovascular events in patients who received testosterone therapy.
The research team led by Rebecca Vigen, M.D., M.S.C.S., of the University of Texas Southwestern Medical Center evaluated the association between testosterone therapy and all-cause mortality, myocardial infarction (MI, or heart attack), and stroke. They also studied whether this association was affected by underlying coronary artery disease (CAD).
Researchers measured the rates of adverse cardiovascular events in 8,709 male patients with low testosterone levels who underwent coronary angiography between 2005 and 2011. The proportion of patients who experienced the events in 3 years were 19.9% in no-testosterone therapy group and 25.7% in testosterone therapy group. Parameters of blood pressure, low-density lipoprotein levels and use of secondary prevention medications were similar in those groups and made no difference in results. They concluded that, even accounting for other factors, the use of testosterone therapy was associated with adverse outcomes and was consistent among patients with and without CAD.
“Perhaps the most important question is the generalizability of the results of this study to the broader population of men taking testosterone: men of this age group (around 60 years old) who are taking testosterone for ‘low T syndrome’ or for anti-aging purposes and younger men taking it for physical enhancement,” wrote Anne R. Cappola, M.D., Sc.M., of the Perelman School of Medicine at the University of Pennsylvania in an accompanying editorial.