Hamad Medical Corporation
Less mortality and less major adverse cardiovascular events (MACE) under long-term testosterone therapy (TTh): 15-year data from a prospective controlled registry study
Ahmad Al-Qudimat1, Read R AlZobui 1, Mustafa Alwani3, Omar Aboumarzouk1, Abdulla Alansari1, Karim Haider2, Farid Saad4, Aksam Yassin1, Raidh Talib1.
1Surgery, Hamad Medical Corporation, Doha, Qatar; 2Surgery, Klinikum Bremen-Mitte , Berlin, Germany; 3School of Medicine , Jordan University of Science and Technology , Amman, Jordan; 4Preventive Medicine, Dresden International University, Dresedn, Germany
Introduction: We have previously demonstrated improvements in cardiometabolic risk factors in hypogonadal men on long-term TTh.
Methods: Cumulative registry study to investigate long-term effectiveness and safety of 3-monthly TU to treat hypogonadism was established in 2004 in a urological setting. Of 805 hypogonadal men, 412 received parenteral TU 1000 mg/12 weeks (T-group) for up to 12 years. 393 men opted against TTh and served as controls (CTRL). 10-year data are reported. Confounders including age, BMI, smoking, alcohol, total and HDL cholesterol, systolic blood pressure, and type 2 diabetes were assessed and considered in statistical modeling.
Results: Baseline age was 57.7±7.4 in the T-group and 63.7±4.8 years in CTRL (p<0.001). The absolute follow-up time comprised approximately 6.500 patient-years. The mean Framingham risk score at baseline was 15.5 in the T-group and 15.8 in CTRL (p<0.05). The mean 10-year risk was 22.7% in the T-group and 23.5% in CTRL (p=0.11). Mean and median observation time in the T-group was 8 years. There were 16 deaths (3.9%) but no myocardial infarctions or strokes. Mean observation time in CTRL was 8, median 9 years. There were 74 deaths (18.8%), 70 MIs (17.8%) and 59 strokes (15%). All classical cardiovascular risk factors including obesity, glycaemic control, lipid pattern, and C-reactive protein improved in the T-group and worsened in CTRL. The reduction of cardiovascular events by TTh after applying a linear mixed effect model was 24.7% and 15.5% after applying a random effect longitudinal model.
Conclusions: In hypogonadal men, long-term TTh reduces cardiovascular events and mortality.