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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Testosterone increases soft plaque buildup?
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<blockquote data-quote="madman" data-source="post: 227127" data-attributes="member: 13851"><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/no-evidence-of-adverse-cardiovascular-events-and-mortality-in-men-during-testosterone-treatment.25444/[/URL]</p><p></p><p></p><p><strong>Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis (2022)</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong><em>In summary, our findings indicate that testosterone treatment did not increase the risks of any subtype of a cardiovascular event in men with hypogonadism and did not identify any patient characteristics that were associated with a significantly increased risk of cardiovascular events during testosterone treatment.</em></strong><em><strong> Furthermore, we observed a similar mortality rate during testosterone treatment when compared with placebo, which was reassuring.</strong> A meta-analysis of several observational studies63 reported an association between low endogenous testosterone concentrations and increased risk of cardiovascular events, suggesting, notwithstanding the possibility of reverse causality, that testosterone therapy might result in some beneficial effects on the cardiovascular system. </em><strong><em>According to the results of our analysis, the overall short to the medium-term effect of testosterone seems neutral.</em></strong></p><p></p><p><em>In view of the lack of consistent cardiovascular event classification, adjudication, or reporting within trials, we did a masked analysis of each individual adverse event by two independent clinicians to classify cardiovascular events from all IPD studies objectively. We successfully obtained data from 3431 (61·3%) of the 5601 participants included in eligible published trials, but IPD from some studies could not be included due to data loss, retirement or death of lead investigators or unwillingness of two pharmaceutical sponsors (Bayer AG, Kyowa Kirin) to disclose them. To assess the effect of studies for which IPD were not available, we extracted appropriate aggregate study-level data and incorporated them alongside the IPD using two-stage IPD random-effect meta-analyses.64 Our aggregate meta-analysis suggested that outcome data were not significantly discrepant between our IPD and non-IPD studies.<strong> Nevertheless, we cannot exclude that a high number of unreported cardiovascular events in the nonIPD studies could ultimately change the conclusions of our analysis.</strong> <strong>The very small total number of deaths recorded during testosterone trials limits our ability to analyze why they occurred. <u>The mean follow-up of included randomized controlled trials was 9·5 months, which might be too short for atherosclerotic plaque progression to accrue</u>. <u>This is important since the Testosterone Trials observed that a 12-month duration of testosterone treatment was associated with a significantly greater increase in coronary artery non-calcified plaque volume versus placebo, in older men</u>.65<u> This finding has led some to advocate coronary artery calcium scoring before treatment of high-risk individuals with underlying cardiovascular disease, due to the remaining possibility that testosterone might be riskier in such individuals</u>.</strong></em></p><p></p><p><strong><em>*However, we observed no significant associations between existing (baseline) cardiovascular or cerebrovascular events and risks of future events during the first 9·5 months after initiation of testosterone treatment</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 227127, member: 13851"] [URL unfurl="true"]https://www.excelmale.com/forum/threads/no-evidence-of-adverse-cardiovascular-events-and-mortality-in-men-during-testosterone-treatment.25444/[/URL] [B]Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis (2022) [I]In summary, our findings indicate that testosterone treatment did not increase the risks of any subtype of a cardiovascular event in men with hypogonadism and did not identify any patient characteristics that were associated with a significantly increased risk of cardiovascular events during testosterone treatment.[/I][/B][I][B] Furthermore, we observed a similar mortality rate during testosterone treatment when compared with placebo, which was reassuring.[/B] A meta-analysis of several observational studies63 reported an association between low endogenous testosterone concentrations and increased risk of cardiovascular events, suggesting, notwithstanding the possibility of reverse causality, that testosterone therapy might result in some beneficial effects on the cardiovascular system. [/I][B][I]According to the results of our analysis, the overall short to the medium-term effect of testosterone seems neutral.[/I][/B] [I]In view of the lack of consistent cardiovascular event classification, adjudication, or reporting within trials, we did a masked analysis of each individual adverse event by two independent clinicians to classify cardiovascular events from all IPD studies objectively. We successfully obtained data from 3431 (61·3%) of the 5601 participants included in eligible published trials, but IPD from some studies could not be included due to data loss, retirement or death of lead investigators or unwillingness of two pharmaceutical sponsors (Bayer AG, Kyowa Kirin) to disclose them. To assess the effect of studies for which IPD were not available, we extracted appropriate aggregate study-level data and incorporated them alongside the IPD using two-stage IPD random-effect meta-analyses.64 Our aggregate meta-analysis suggested that outcome data were not significantly discrepant between our IPD and non-IPD studies.[B] Nevertheless, we cannot exclude that a high number of unreported cardiovascular events in the nonIPD studies could ultimately change the conclusions of our analysis.[/B] [B]The very small total number of deaths recorded during testosterone trials limits our ability to analyze why they occurred. [U]The mean follow-up of included randomized controlled trials was 9·5 months, which might be too short for atherosclerotic plaque progression to accrue[/U]. [U]This is important since the Testosterone Trials observed that a 12-month duration of testosterone treatment was associated with a significantly greater increase in coronary artery non-calcified plaque volume versus placebo, in older men[/U].65[U] This finding has led some to advocate coronary artery calcium scoring before treatment of high-risk individuals with underlying cardiovascular disease, due to the remaining possibility that testosterone might be riskier in such individuals[/U].[/B][/I] [B][I]*However, we observed no significant associations between existing (baseline) cardiovascular or cerebrovascular events and risks of future events during the first 9·5 months after initiation of testosterone treatment[/I][/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Testosterone increases soft plaque buildup?
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