Testosterone Therapy Linked to Reduced MACE Risk in Men with Hypogonadism

This article was originally published on EndocrinologyNetwork.com.

Omar Aboumarzouk, PhD

Data from a 10-year study including more than 800 men suggests testosterone therapy could reduce risk of major adverse cardiovascular events (MACE) among men with testosterone deficiency.

Presented at the Annual Congress of the European Association of Urology (EAU21), results of the study indicate men with testosterone deficiency receiving testosterone therapy had a lower risk of mortality and MACE than their counterparts who did not undergo testosterone therapy.

"Given that all these men would normally have been expected to suffer a heart attack or stroke in the next 5 to 10 years, with no other intervention, it was a real surprise to see no cardiovascular events at all in the group on testosterone therapy. It's clear that this treatment can significantly reduce the risks in this particular group,” said study presenter Omar Aboumarzouk, PhD, of the Hamad Medical Corporation in Qatar, in a statement.

A cumulative registry study designed to assess the long-term safety and efficacy of testosterone therapy in hypogonadal men, the EAU21 study included 805 participants, including 412 receiving 1000 mg of parenteral testosterone every 12 weeks for up to 12 years and 393 who opted against receiving testosterone therapy who served as controls. All patients included in the study were at increased risk of cardiovascular disease due to family history, blood pressure, lipid profile, diabetes status, or body weight.

Upon analysis, results indicated those in the testosterone therapy group had a 10-year mean risk of 22.7% compared to 23.5% among those in the control arm (P=.11). Over a median follow-up of 8 years, 16 deaths occurred in the testosterone therapy group. Investigators pointed out there were no observed incidences of myocardial infarction or stroke among these patients. Over a median follow-up time of 9 years, a total of 74 deaths occurred among those in the control arm. Investigators pointed out 70 incidences of myocardial infarction and 59 cases of stroke were observed among these patients.

Additionally, further analysis suggested use of testosterone therapy was associated with improvements in multiple classical cardiovascular risk factors, including obesity, glycemic control, lipid profile, and CRP.

In the aforementioned statement, Maarten Albersen, Member of the EAU Scientific Office, from Leuven University in Belgium, commended study authors for their study’s addition to the existing knowledge base but cautioned more research into the effects of testosterone on cardiovascular health is needed before drawing a definitive conclusion.

“These were men with a medium risk of heart attack or stroke, and those receiving testosterone were younger and had a slightly lower risk at the start of the study. The study was long enough to see differences in the rate of cardiovascular events,” pointed out Albersen. “However, the numbers involved and the fact that the trial was not randomised mean it's still difficult to draw any hard conclusions. A new trial is now underway, aiming to recruit 6000 participants, and this should provide definitive answers on the cardiovascular risks or even benefits of hormone therapy in men with low testosterone."

This study, “Less mortality and less Major Adverse Cardiovascular Events (MACE) under long-term Testosterone Therapy (TTh): 15-year data from a prospective controlled registry study,” was presented at the Annual Congress of the European Association of Urology.