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Cited by 128Hormonal and reproductive studiesSexual function and dysfunction studiesThyroid Disorders and Treatments

Low Testosterone is Associated with an Increased Risk of MACE Lethality in Subjects with Erectile Dysfunction

Corona, Giovanni, Monami, Matteo, Boddi, Valentina, Cameron-Smith, Michela, Fisher, Alessandra D., De Vita, Giulia, Melani, Cecilia, Balzi, Daniela +4 more·2010·The Journal of Sexual Medicine
DOI 10.1111/j.1743-6109.2009.01690.x
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Abstract

Introduction: Although testosterone (T) has been suggested to play a protective role against the development of atherosclerosis, studies demonstrating an association between low T and incident major adverse cardiovascular events (MACE) are scanty in the general population and absent in subjects with erectile dysfunction (ED). Aim: To investigate whether low T in subjects with ED predict incident fatal or nonfatal MACE. Methods: This is an observational prospective cohort study evaluating a consecutive series of 1687 patients attending our andrological unit for ED. Patients were interviewed using the structured interview on erectile dysfunction (SIEDY) and ANDROTEST structured interviews measuring components relative to ED and hypogonadal-related symptoms, respectively. Main Outcome Measures: Total T was evaluated at baseline. Information on MACE was obtained through the City of Florence Registry Office. Results: Among the patients studied, 5.2, 13.8, and 22.4% were hypogonadal according to different thresholds (T<8, 10.4 and 12 nmol/L or 230, 300 and 350 ng/dL, respectively). During a mean follow-up of 4.3 ± 2.6 years, 139 MACE, 15 of which were fatal, were observed. Unadjusted incidence of MACE was not associated with T levels. Conversely, the proportion of lethal events among MACE was significantly higher in hypogonadal patients, using either 10.4 nmol/L (300 ng/dL) or 8 nmol/L (230 ng/dL) thresholds. However, after adjustment for age and Chronic Diseases Score in a Cox regression model, only the association between incident fatal MACE and T<8 nmol/L (230 ng/dL) was confirmed (HR=7.1 [1.8–28.6]; P <0.001). Interestingly, measuring hypogonadal-related symptoms and signs through ANDROTEST, only fatal MACE were also associated with a higher score (HR=1.2 [1.0–1.5] for each ANDROTEST score increment; P = 0.05 after adjustment for age and Chronic Diseases Score). Conclusions: T levels are associated with a higher mortality of MACE. The identification of low T levels should alert the clinician thus identifying subjects with an increased cardiovascular risk.

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  • Testosterone levels are linked to a variety of conditions and diseases, such as cardiovascular disease, type-2 diabetes, the metabolic syndrome, erectile dysfunction, depression, obesity, stroke and osteoporosis.

    “Several studies have previously reported that testosterone levels are linked to a variety of conditions and diseases, such as cardiovascular disease, type-2 diabetes, the metabolic syndrome, erectile dysfunction, depression, obesity, stroke and osteoporosis. 1-7”

    From Cigarette smoking has a positive and independent effect on testosterone levels (2013) · cites this paper as [6]

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Authors
Corona, G., Monami, M., Boddi, V., Cameron-Smith, M., Fisher, A. D., De Vita, G., Melani, C., Balzi, D., Sforza, A., Forti, G., Mannucci, E., & Maggi, M.
Affiliations
  • Ospedale Bellaria (IT)
  • University of Florence (IT)
  • Andrology Unit, Department of Clinical Physiopathology, University of Florence , Florence , Italy
  • Azienda Sanitaria di Firenze (IT)
Corresponding author
Maggi, Mario
ORCID
Venue
The Journal of Sexual Medicine
Publisher
Oxford University Press (OUP)
Published
2010-04-01
Volume
7
Issue
4_Part_1
Pages
1557-1564
ISSN
  • 1743-6095 (ISSN-L)
  • 1743-6109
DOI
10.1111/j.1743-6109.2009.01690.x
OpenAlex
W2143849209
Cited by
128
References
10
Citations by year
2024: 3 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 10 · 2016: 4 · 2015: 8 · 2014: 24 · 2013: 21 · 2012: 15
FWCI
13.44
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Sexual Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Keywords
androgen deficiency, erectile dysfunction, major adverse cardiovascular events, cardiovascular mortality, hypogonadism, cardiovascular risk, atherosclerosis
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Cause of Death, Humans, Hypogonadism, Italy, Longitudinal Studies, Male, Middle Aged, Registries, Risk Factors, Testosterone, Biomarkers, Comorbidity, Impotence, Vasculogenic, Kaplan-Meier Estimate, Young Adult

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