Testosterone replacement protects men with preexisting heart disease

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[style=font-weight:bold;]1206M-07 - Clinical Effects of Testosterone Supplementation Among Hypo-Androgenic Men With Preexisting Severe Coronary Artery Disease: The Intermountain Heart Collaborative Study[/style]





http://www.abstractsonline.com/pp8/#!/3874/presentation/43323









Authors

Tami L. Bair, Heidi May, Viet T. Le, Donald Lappe, Jeffrey Anderson, J. Muhlestein, Intermountain Medical Center, Murray, UT, USA



Abstract



Introduction: Low serum testosterone (T) is an independent risk factor for CV and total mortality. The impact of T therapy on CV outcomes, especially among older men with pre-existing severe CAD, is unknown.



Methods: All men >50 yrs of age, with severe CAD (&#8805;70% stenosis), a low (<212 ng/dL) baseline T level, 1 follow-up (f/u) T level and 3 yrs of clinical f/u were evaluated. T was stratified into categories: persistent low (742). Cox hazard regression analysis was performed to associate T categories with major adverse cardiovascular events (MACE) including death [D], non-fatal MI, and stroke.



Results: A total of 755 men (age 68.0 ± 9.6 y, diabetes: 50%, hypertension: 83%, hyperlipidemia: 81%, smokers: 33%, prior MI: 23%) were studied. Event rates at 1 and 3-y by achieved T level, and adjusted HRs, are shown in Table. Overall 3-y rates of MACE, D and MI were 24.5%, 17.6% and 8.1% respectively. Pts supplemented to normal/high T had reduced 3-y MACE (HR=0.77 [0.56-1.04]), D (HR=0.67 [0.47-0.97]) and MI (HR 0.52 [0.31, 0.87]) compared to low T subjects. Results were similar for 1-y MACE (HR=0.63 [0.40, 1.00]), D (HR=0.93 [0.51, 1.69]) and MI (HR=0.26 [0.31, 0.87]).



Conclusions: Among elderly men with severe CAD and low T, T therapy was associated with reduced MACE, D and MI over 3-y compared to no or ineffective supplementation. A marked protective effect of T supplementation on MI incidence during first yr of f/u was noted, giving further evidence of CV safety associated with T supplementation.
 
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