Late-Onset Hypogonadism Effects on Coronary Heart Disease

Abstract

A total of 161 men with at a mean age of 58 (52; 64) years were available for examination. Sixty of them presented with coronary artery disease and confirmed late-onset hypogonadism, 80 had coronary artery disease and normal testosterone, 21 had no coronary artery disease and no hypogonadism. The study included echocardiography, Holter monitoring, heart computed tomography, coronarography and estimation of depression level. We found that low testosterone in patients with coronary artery disease is associated with decreased left ventricular ejection fraction, atypical anginal syndrome and subclinical depression. Men with androgen deficiency and ischemic heart disease have lower heart rate variability, longer time of ST interval depression and greater amount of extrasystoles, than patients with ischemic heart disease and no androgen deficiency. There is a negative correlation between total testosterone and amount of myocardial revascularisation operations in men with normal testosterone. Patients with free testosterone <9pg/ml have more severe coronary artery disease than men with free testosterone >9pg/ml according to coronary angiography.