Low serum testosterone and increased mortality in men with coronary heart disease
Open accessAbstract
Background: To examine the effect of serum testosterone levels on survival in a consecutive series of men with confirmed coronary disease and calculate the prevalence of testosterone deficiency. Design: Longitudinal follow-up study. Setting: Tertiary referral cardiothoracic centre. Patients: 930 consecutive men with coronary disease referred for diagnostic angiography recruited between June 2000 and June 2002 and followed up for a mean of 6.9±2.1 years. Outcome: All-cause mortality and vascular mortality. Prevalence of testosterone deficiency. Results: The overall prevalence of biochemical testosterone deficiency in the coronary disease cohort using bio-available testosterone (bio-T) <2.6 nmol/l was 20.9%, using total testosterone <8.1 nmol/l was 16.9% and using either was 24%. Excess mortality was noted in the androgen-deficient group compared with normal (41 (21%) vs 88 (12%), p=0.002). The only parameters found to influence time to all-cause and vascular mortality (HR ± 95% CI) in multivariate analyses were the presence of left ventricular dysfunction (3.85; 1.72 to 8.33), aspirin therapy (0.63; 0.38 to 1.0), β-blocker therapy (0.45; 0.31 to 0.67) and low serum bio-T (2.27; 1.45 to 3.6). Conclusions: In patients with coronary disease testosterone deficiency is common and impacts significantly negatively on survival. Prospective trials of testosterone replacement are needed to assess the effect of treatment on survival.
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Observational studies have demonstrated that TRT reduces intima media thickening regardless of BMI, increases coronary artery diameter and rate of blood flow, and improves time to cardiac ischemia in men with coronary heart disease.
“Observational studies have demonstrated that TRT reduces the intima media thickening regardless of body mass index (BMI), increases coronary artery diameter and the rate of blood flow, and improves time to cardiac ischemia in men with coronary heart disease [13].”
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References 34 · Cited by 236
Research works printed but not linked: 1
- Coronary artery disease on July 29, 2023 by guest. Protected by copyright. http://heart.bmj.com/ Heart: first published as 10.1136/hrt.2010.195412 on 19 October 2010. Downloaded from REFERENCES
- Authors
- Malkin, C. J., Pugh, P. J., Morris, P. D., Asif, S., Jones, T. H., & Channer, K. S.
- Affiliations
- Royal Hallamshire Hospital (GB)
- Barnsley Hospital NHS Foundation Trust (GB)
- Corresponding author
- Channer, Kevin S
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2010-10-19
- Volume
- 96
- Issue
- 22
- Pages
- 1821-1825
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2108445060
- Cited by
- 236
- References
- 34
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 3 · 2022: 13 · 2021: 18 · 2020: 5 · 2019: 16 · 2018: 10 · 2017: 15 · 2016: 10 · 2015: 27 · 2014: 33 · 2013: 20 · 2012: 23
- FWCI
- 17.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- serum testosterone, androgen deficiency, coronary artery disease, all-cause mortality, vascular death, left ventricular dysfunction, aspirin therapy, beta-blocker therapy, testosterone replacement therapy, men
- MeSH terms
- Adult, Aged, Coronary Disease, England, Epidemiologic Methods, Humans, Hypogonadism, Male, Middle Aged, Testosterone
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