LOS ANGELES — The use of testosterone replacement therapy in veterans with CAD who underwent coronary angiography is associated with an increased risk for MI and death, when compared with no testosterone therapy use, according to data presented here.
The association between testosterone replacement therapy and mortality and MI appeared stronger among patients with no VAD than those with CAD.
Rebecca Vigen, MD, MPA, from the cardiology section of VA Eastern Colorado Health Care System in Denver, Colorado, and colleagues used the VA CART-CL registry to find veterans who underwent coronary angiography between 2005 and 2011 and had total testosterone levels ≤300 ng/dL following their procedure.
The researchers studied 8,849 veterans, 15% of whom were administered testosterone replacement therapy an average of 418 days following coronary angiography.
Vigen reported a significant association between the use of testosterone replacement therapy and all-cause mortality and acute MI (HR=1.45; 95% CI, 1.14-1.86). This relationship appeared stronger among patients who did not have significant CAD on angiography (HR=3.17; 95% CI, 1.62-6.20).
“A significant portion of men undergoing angiography, who had levels checked, had a total testosterone level of <300 mg/dL. Testosterone replacement therapy use was associated with all-cause mortality and acute MI in veterans. This relationship was stronger among patients with no CAD vs. those with CAD on angiography,” Vigen said.
Prescriptions for testosterone replacement therapy increased from about 700,000 in 2000 to more than 2.5 million in 2008, according to Vigen.
“These findings may have potential implications for targeting testosterone use among selected patient populations,” the researchers said. – by Samantha Costa
For more information:
Vigen R. Abstract #19261. Presented at: the American Heart Association Scientific Sessions; Nov. 3-7, 2012; Los Angeles.
Disclosure: Vigen reports supported from a Cardiovascular Outcomes Research Fellowship through a Department of Veterans Affairs Graduate Medical Education Enhancement Grant.