Impact of Testosterone Replacement Therapy on Myocardial Infarction, Stroke, and Death in Men With Low Testosterone Concentrations in an Integrated Health Care System

The American Journal of Cardiology
Jeffrey L AndersonJoseph B Muhlestein

Abstract

The aim of this study was to assess the effect of testosterone replacement therapy (TRT) on cardiovascular outcomes. Men (January 1, 1996, to December 31, 2011) with a low initial total testosterone concentration, a subsequent testosterone level, and >3 years of follow-up were studied. Levels were correlated with testosterone supplement use. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of death, nonfatal myocardial infarction, and stroke at 3 years. Multivariate adjusted hazard ratios (HRs) comparing groups of persistent low (<212 ng/dl, n = 801), normal (212 to 742 ng/dl, n = 2,241), and high (>742 ng/dl, n = 1,694) achieved testosterone were calculated by Cox hazard regression. A total of 4,736 men were studied. Three-year rates of MACE and death were 6.6% and 4.3%, respectively. Subjects supplemented to normal testosterone had reduced 3-year MACE (HR 0.74; 95% confidence interval [CI] 0.56 to 0.98, p = 0.04) compared to persistently low testosterone, driven primarily by death (HR 0.65, 95% CI 0.47 to 0.90). HRs for MI and stroke were 0.73 (95% CI 0.40 to 1.34), p = 0.32, and 1.11 (95% CI 0.54 to 2.28), p = 0.78, respectively. MACE was noninferior but not superior for high achieve...Continue Reading

References

Jun 3, 2009·The American Journal of Medicine·Benjamin D HorneJeffrey L Anderson
Jul 2, 2010·The New England Journal of Medicine·Shehzad BasariaShalender Bhasin
Apr 13, 2012·The Journal of Clinical Endocrinology and Metabolism·Molly M ShoresAlvin M Matsumoto
Aug 14, 2013·JAMA Internal Medicine·Jacques BaillargeonJames S Goodwin
Nov 7, 2013·JAMA : the Journal of the American Medical Association·Rebecca VigenP Michael Ho
Jul 6, 2014·The Annals of Pharmacotherapy·Jacques BaillargeonJames S Goodwin
Feb 1, 2015·Mayo Clinic Proceedings·Abraham MorgentalerAbdulmaged M Traish

❮ Previous
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Citations

Oct 30, 2016·The Lancet. Diabetes & Endocrinology·Oluwadamilola OnasanyaG Caleb Alexander
Nov 4, 2016·Current Treatment Options in Cardiovascular Medicine·Dimitri C CassimatisNanette K Wenger
Sep 23, 2016·PloS One·Samantha HuoAdriane Fugh-Berman
Apr 4, 2017·Journal of Molecular and Cellular Cardiology·John P HeadrickNicolas J C Stapelberg
Feb 14, 2017·Gastroenterology·Leon I IgelLouis J Aronne
Mar 21, 2017·International Journal of Clinical Practice·Geoffrey HackettAsif Muneer
Jun 2, 2017·European Journal of Endocrinology·Lina SchifferMichael W O'Reilly
Jan 31, 2018·International Journal of Clinical Practice·Geoffrey Hackett, Michael Kirby
Mar 22, 2018·The Journal of Clinical Endocrinology and Metabolism·Shalender BhasinMaria A Yialamas
Apr 20, 2018·Clinical Cardiology·Michael A RosenbergKenneth J Mukamal
Aug 14, 2018·Expert Review of Cardiovascular Therapy·Giulia RastrelliGiovanni Corona
Jul 12, 2018·Panminerva Medica·Sevann HeloNicholas N Tadros
Aug 5, 2016·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Abdulmaged M Traish
Sep 10, 2019·Expert Opinion on Drug Safety·Abraham Morgentaler, Monica Caliber
Jan 29, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Marco Marcelli, Sanjay Navin Mediwala
Nov 17, 2016·Investigative and Clinical Urology·Abdulmaged Traish
Feb 20, 2020·Journal of Hypertension·Margus ViigimaaUNKNOWN European Society of Hypertension Working Group on Sexual Dysfunction
Oct 21, 2015·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·G I Hackett
Aug 7, 2018·The World Journal of Men's Health·Geoffrey Hackett
Aug 2, 2018·The Aging Male : the Official Journal of the International Society for the Study of the Aging Male·L Y MorgunovV I Skvortsova
Oct 27, 2018·Therapeutic Advances in Drug Safety·M Reza SadaieGary A Thomas
Dec 19, 2018·Journal of Clinical Medicine·Abdulmaged TraishAbraham Morgentaler
May 1, 2019·Journal of Cardiovascular Development and Disease·Jennifer L RodgersSiva K Panguluri
Jul 30, 2019·Physiological Reports·Munthana WadthaisongPieter P de Tombe
Jul 31, 2020·Biology of Sex Differences·Tori Stone, Nina S Stachenfeld
Jul 31, 2019·European Cardiology·Michael KirbySudarshan Ramachandran
May 28, 2019·Nature Reviews. Cardiology·Thiago Gagliano-Jucá, Shehzad Basaria
Oct 17, 2019·European Endocrinology·Cornelius J FernandezJoseph M Pappachan
May 1, 2018·The World Journal of Men's Health·Jonathan Clavell-Hernández, Run Wang
Jul 26, 2017·Methodist DeBakey Cardiovascular Journal·Travis GoodaleRichard Robbins
Aug 11, 2020·Current Opinion in Critical Care·Paul E WischmeyerAmy M Pastva

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