Relation of Testosterone Normalization to Mortality and Myocardial Infarction in Men With Previous Myocardial Infarction

Oni, Omobowale A.; Dehkordi, Seyed Hamed Hosseini; Jazayeri, Mohammad-Ali; Sharma, Rishi; Sharma, Mukut; Masoomi, Reza; Sharma, Ram; Gupta, Kamal; Barua, Rajat S.

doi:10.1016/j.amjcard.2019.07.019

Cited by 25 publications

(9 citation statements)

References 30 publications

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“…Moreover, Oni et al demonstrated in a large observational cohort of male veterans with previous myocardial infarction (MI), normalization of TT levels with TTh was associated with decreased all-cause mortality compared with those with non-normalized TT levels and the untreated group. Furthermore, in this high-risk population, TTh was not associated with an increased risk of recurrent MI [168].…”

Section: Recommendation 10: Testosterone Cardiovascular Disease and All-cause Mortalitymentioning

confidence: 59%

Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men

Lunenfeld

Mskhalaya²,

Zitzmann

et al. 2021

The Aging Male

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The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age globally. One in four persons living in Europe and Northern America will be aged 65 or over. One of the goals of ISSAM is to raise awareness of the special health needs of older men. Since a significant number of aging men will eventually become testosterone deficient, the Hypogonadism panel of ISSAM updates its guidelines.

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Section: Recommendation 10: Testosterone Cardiovascular Disease and All-cause Mortalitymentioning

confidence: 59%

Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men

Lunenfeld

Mskhalaya²,

Zitzmann

et al. 2021

The Aging Male

View full text Add to dashboard Cite

show abstract

“…Additionally, when Hyde et al investigated causes of death in 605 patients from a 5- [15]. Conversely, in a retrospective study of 1470 men with documented low TT levels and previous myocardial infarction, Oni et al proved that normalization of TT levels with testosterone replacement therapy (TRT) was associated with decreased all-cause mortality compared with those with non-normalized TT levels (HR: 0.76, 95% CI: 0.64-0.90) and the untreated group (HR: 0.76, 95% CI: 0.60-0.98) [19]. Considering that most of the aforementioned studies were conducted on Caucasians, the current study investigated the relationship between endogenous testosterone and CVE in Asians, with our results suggesting the clinical importance of measuring testosterone levels in Caucasians as well as Asians.…”

Section: Discussionmentioning

confidence: 99%

Low free testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors

et al. 2021

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Aim: We investigated whether low plasma free testosterone (FT) levels could predict cardiovascular events (CVE) in Japanese men with coronary risk factors. Methods: Male patients with classical coronary risk factors who had undergone serum FT testing were enrolled. New incidences of CVE were retrospectively investigated among all eligible participants based on their medical records. Results: Overall, 466 male outpatients with coronary risk factors without a previous history of CVE were identified. Throughout the follow-up period (median ¼ 92 months), 126 CVE occurred. The Kaplan-Meier survival analysis according to the tertiles of plasma FT levels revealed that patients with the lowest FT tertile (<6.5 pg/mL) had a higher likelihood of developing CVE than those with the highest tertile (>9.3 pg/mL) (p<.01). Multivariate analysis showed that increased frequency of CVE was observed with lower FT tertiles, independent of other coronary risk factors, with hazard ratios of 0.617 (95% CI, 0.389-0.976; p¼.030) and 0.524 (95% CI, 0.309-0.887; p¼.016) for the second and highest tertile relative to the lowest FT tertile, respectively. Conclusion: Among Japanese men with coronary risk factors, a lower FT level was a predictor for the development of cardiovascular diseases independent of other coronary risk factors and age.

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“…[16][17][18] However, not all studies found this association between testosterone and increased risk of death or cardiovascular outcomes, and some studies even reported cardiovascular advantages. 19,20,42…”

Section: Discussionmentioning

confidence: 99%

Health Outcomes Among Long-term Opioid Users With Testosterone Prescription in the Veterans Health Administration

et al. 2019

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IMPORTANCE Androgen deficiency is common among male opioid users, and opioid use has emerged as a common antecedent of testosterone treatment. The long-term health outcomes associated with testosterone therapy remain unknown, however. OBJECTIVE To compare health outcomes between long-term opioid users with testosterone deficiency who filled testosterone prescriptions and those with the same condition but who did not receive testosterone treatment. DESIGN, SETTING, AND PARTICIPANTS This cohort study focused on men in the care of the Veterans Health Administration (VHA) facilities throughout the United States from October 1, 2008, to September 30, 2014. It included male veterans who were long-term opioid users, had low testosterone levels (<300 ng/dL), and received either a testosterone prescription or any other prescription. It excluded male patients with HIV infection, gender dysphoria, or prostate cancer and those who received testosterone in fiscal year 2008. Data were analyzed from April 1, 2017, to April 30, 2019. EXPOSURE Prescription for testosterone. MAIN OUTCOMES AND MEASURES All-cause mortality and incidence of major adverse cardiovascular events (MACE), vertebral or femoral fractures, and anemia during the 6-year follow-up through September 30, 2015. RESULTS After exclusions, 21 272 long-term opioid users (mean [SD] age, 53 [10] years; n = 16 689 [78.5%] white) with low total or free testosterone levels were included for analysis, of whom 14 121 (66.4%) received testosterone and 7151 (33.6%) did not. At baseline, compared with opioid users who did not receive testosterone, long-term opioid users who received testosterone treatment were more likely to have obesity (43.7% vs 49.0%; P < .001), hyperlipidemia (43.0% vs 48.8%; P < .001), and hypertension (53.9% vs 55.2%; P = .07) but had lower prevalence of coronary artery disease (15.9% vs 12.9%; P < .001) and stroke (2.4% vs 1.3%; P < .001). After adjusting for covariates, opioid users who received testosterone had significantly lower all-cause mortality (hazard ratio [HR] = 0.51; 95% CI, 0.42-0.61) and lower incidence of MACE (HR = 0.58; 95% CI, 0.51-0.67), femoral or hip fractures (HR = 0.68; 95% CI, 0.48-0.96), and anemia (HR = 0.73; 95% CI, 0.68-0.79) during the follow-up period of up to 6 years, compared with their counterparts without a testosterone prescription. In covariate-adjusted models, men who received opioids plus testosterone were more likely to have resolved anemia compared with those who received opioids only during the 6-year follow-up (HR = 1.16; 95% CI, 1.02-1.31). Similar results were obtained in propensity score-matched models and when analyses were restricted to opioid users with noncancer pain or those who did not receive glucocorticoids. (continued) Key Points Question What are the health outcomes among long-term opioid users who receive testosterone treatment compared with opioid users who do not? Findings In this cohort study of 21 272 male long-term opioid users with testosterone deficiency, those who received opioids plus testo...

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Relation of Testosterone Normalization to Mortality and Myocardial Infarction in Men With Previous Myocardial Infarction

Cited by 25 publications

References 30 publications

Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men

Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men

Low free testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors

Health Outcomes Among Long-term Opioid Users With Testosterone Prescription in the Veterans Health Administration

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