Normalization of Testosterone levels with TRT lowers mortality risk in Men
Testosterone replacement therapy in male veterans with prior MI was not associated with an increased risk for recurrent MI and was found to decrease all-cause mortality in those whose total testosterone levels returned to normal, according to data published in the American Journal of Cardiology.
Normalization of total testosterone levels in male veterans with hypogonadism and previous MI using testosterone replacement therapy associated with decreased risk for all-cause mortality compared with those whose levels did not normalize or those who did not receive testosterone replacement therapy.
Additionally, researchers found no significant rise in recurrent MI after the hypogonadal men received testosterone replacement therapy, despite whether they achieved normalized testosterone levels or did not.
?The lack of reduction in MI after [testosterone replacement therapy] in patients with prior MI suggests normalization of [total testosterone] alone may not be sufficient to reduce MI events in this high-risk population,? the authors wrote. ?Given the multifactorial nature of atherosclerotic CAD and complex pathophysiology of ACS, a comprehensive risk factor reduction strategy is needed to reduce the risk of recurrent MI.?
Cardiology Today corresponded with Rajat S. Barua, MD, PhD, FACC, FSCAI, chief of cardiology at Kansas City VA Medical Center, regarding the implications of this study.
?This study, taken together with our previous study in patients without previous MI or stroke (Sharma R, et al. Eur Heart J. 2015;doi:10.1093/eurheartj/ehv346), we can infer two things: [In] truly hypogonadal patients, total testosterone normalization through testosterone replacement therapy is likely to benefit patients in terms of all-cause-mortality. In patients without previous MI and stroke, appropriate testosterone replacement therapy is likely to benefit patients in terms of CV events,? Barua said. ?[Secondly], in patients with previous MI, we did not see increased harm and also we did not see a reduction in MI event, thus, suggesting a possible neutral effect of testosterone replacement therapy in terms of CV events in this patient population.?
In this retrospective study, researchers analyzed the patient data of 1,470 male veterans with prior MI and documented low total testosterone. Patients were divided into three groups: patients who received testosterone replacement therapy and had normalization of total testosterone levels (n = 755); patients who received testosterone replacement therapy without normalization of total testosterone levels (n = 542); and patients with low total testosterone and received no testosterone replacement therapy (n = 173).
Testosterone replacement therapy in male veterans with prior MI was not associated with an increased risk for recurrent MI and was found to decrease all-cause mortality in those whose total testosterone levels returned to normal, according to data published in the American Journal of Cardiology.
Normalization of total testosterone levels in male veterans with hypogonadism and previous MI using testosterone replacement therapy associated with decreased risk for all-cause mortality compared with those whose levels did not normalize or those who did not receive testosterone replacement therapy.
Additionally, researchers found no significant rise in recurrent MI after the hypogonadal men received testosterone replacement therapy, despite whether they achieved normalized testosterone levels or did not.
?The lack of reduction in MI after [testosterone replacement therapy] in patients with prior MI suggests normalization of [total testosterone] alone may not be sufficient to reduce MI events in this high-risk population,? the authors wrote. ?Given the multifactorial nature of atherosclerotic CAD and complex pathophysiology of ACS, a comprehensive risk factor reduction strategy is needed to reduce the risk of recurrent MI.?
Cardiology Today corresponded with Rajat S. Barua, MD, PhD, FACC, FSCAI, chief of cardiology at Kansas City VA Medical Center, regarding the implications of this study.
?This study, taken together with our previous study in patients without previous MI or stroke (Sharma R, et al. Eur Heart J. 2015;doi:10.1093/eurheartj/ehv346), we can infer two things: [In] truly hypogonadal patients, total testosterone normalization through testosterone replacement therapy is likely to benefit patients in terms of all-cause-mortality. In patients without previous MI and stroke, appropriate testosterone replacement therapy is likely to benefit patients in terms of CV events,? Barua said. ?[Secondly], in patients with previous MI, we did not see increased harm and also we did not see a reduction in MI event, thus, suggesting a possible neutral effect of testosterone replacement therapy in terms of CV events in this patient population.?
In this retrospective study, researchers analyzed the patient data of 1,470 male veterans with prior MI and documented low total testosterone. Patients were divided into three groups: patients who received testosterone replacement therapy and had normalization of total testosterone levels (n = 755); patients who received testosterone replacement therapy without normalization of total testosterone levels (n = 542); and patients with low total testosterone and received no testosterone replacement therapy (n = 173).
