Acute Anti-Ischemic Effect of Testosterone in Men With Coronary Artery Disease
Abstract
Background —The role of testosterone on the development of coronary artery disease in men is controversial. The evidence that men have a greater incidence of coronary artery disease than women of a similar age suggests a possible causal role of testosterone. Conversely, recent studies have shown that the hormone improves endothelium-dependent relaxation of coronary arteries in men. Accordingly, the aim of the present study was to evaluate the effect of acute administration of testosterone on exercise-induced myocardial ischemia in men. Methods and Results —After withdrawal of antianginal therapy, 14 men (mean age, 58±4 years) with coronary artery disease underwent 3 exercise tests according to the modified Bruce protocol on 3 different days (baseline and either testosterone or placebo given in a random order). The exercise tests were performed 30 minutes after administration of testosterone (2.5 mg IV in 5 minutes) or placebo. All patients showed at least 1-mm ST-segment depression during the baseline exercise test and after placebo, whereas only 10 patients had a positive exercise test after testosterone. Chest pain during exercise was reported by 12 patients during baseline and placebo exercise tests and by 8 patients after testosterone. Compared with placebo, testosterone increased time to 1-mm ST-segment depression (579±204 versus 471±210 seconds; P <0.01) and total exercise time (631±180 versus 541±204 seconds; P <0.01). Testosterone significantly increased heart rate at the onset of 1-mm ST-segment depression (135±12 versus 123±14 bpm; P <0.01) and at peak exercise (140±12 versus 132±12 bpm; P <0.01) and the rate-pressure product at the onset of 1-mm ST-segment depression (24 213±3750 versus 21 619±3542 mm Hg×bpm; P <0.05) and at peak exercise (26 746±3109 versus 22 527±5443 mm Hg×bpm; P <0.05). Conclusions —Short-term administration of testosterone induces a beneficial effect on exercise-induced myocardial ischemia in men with coronary artery disease. This effect may be related to a direct coronary-relaxing effect.
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Testosterone therapy with intramuscular, intravenous, and transdermal preparations has a beneficial anti-ischaemic effect in men with coronary disease.
“A number of research groups have reported that testosterone therapy with intramuscular, 14 intravenous, 15 and transdermal preparations had a beneficial anti-ischaemic effect in men with coronary disease.16”
From Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life (2004) · cites this paper as [15]
In the past 30 years, at least six studies of various design have reported effects of androgen therapy on coronary ischaemia; all but one reported a beneficial effect.
“In the past 30 years, at least six studies of various design have reported the effects of androgen therapy on coronary ischaemia 14-16 44-46 ; all but one have reported a beneficial effect.46”
From Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life (2004) · cites this paper as [15]
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- Authors
- Rosano, G. M. C., Leonardo, F., Pagnotta, P., Pelliccia, F., Panina, G., Cerquetani, E., della Monica, P. L., Bonfigli, B., Volpe, M., & Chierchia, S. L.
- Affiliations
- IRCCS Ospedale San Raffaele (IT)
- From the Department of Cardiology, Istituto H. San Raffaele, Roma and Milano, Italy.
- Venue
- Circulation
- Published
- 1999-04-06
- Volume
- 99
- Issue
- 13
- Pages
- 1666-1670
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2118047070
- Cited by
- 367
- References
- 16
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 11 · 2021: 5 · 2020: 7 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 11 · 2014: 21 · 2013: 15 · 2012: 14
- FWCI
- 11.76
- Type
- journal article
- Language
- en
- Update notices
- correction (2000-02-08)
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- testosterone, coronary artery disease, exercise-induced myocardial ischemia, ST-segment depression, coronary vasodilation, chest pain, rate-pressure product, heart rate response to exercise, endothelium-dependent relaxation
- MeSH terms
- Aged, Cardiovascular Agents, Coronary Disease, Electrocardiography, Exercise Test, Humans, Injections, Intravenous, Male, Middle Aged, Testosterone, Myocardial Ischemia
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