Low serum testosterone and increased mortality in men with coronary heart disease

Heart. 2010 Nov;96(22):1821-5. doi: 10.1136/hrt.2010.195412. Epub 2010 Oct 19.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Coronary Disease / blood*
  • Coronary Disease / etiology
  • Coronary Disease / mortality
  • England / epidemiology
  • Epidemiologic Methods
  • Humans
  • Hypogonadism / complications
  • Hypogonadism / mortality
  • Male
  • Middle Aged
  • Testosterone / blood*
  • Testosterone / deficiency

Substances

  • Testosterone