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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Impact of TRT on Adverse Cardiovascular Events in Men with Low Testostosterone: Evaluation of Physiological and Supraphysiological T Levels
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<blockquote data-quote="madman" data-source="post: 275937" data-attributes="member: 13851"><p>[URL unfurl="true"]https://academic.oup.com/jsm/article/21/Supplement_1/qdae001.084/7600775[/URL]</p><p></p><p></p><p><strong>Abstract</strong></p><p><strong></strong></p><p><strong>Introduction</strong></p><p></p><p><em>Sustained treatment with elevated levels of exogenous testosterone (T) has been linked to various adverse events, particularly concerning cardiovascular risks.<strong> However, there is currently a lack of sufficient literature that comprehensively describes the overall safety profile of supraphysiologic testosterone levels.</strong></em></p><p></p><p></p><p><strong>Objective</strong></p><p></p><p><em>To compare the safety profiles and rates of polycythemia, venous thromboembolism (VTE), major adverse cardiac events (MACE), deep vein thrombosis (DVT), myocardial infarction (MI), and stroke <strong>between hypogonadism patients treated with testosterone replacement therapy (TRT) at physiological and supraphysiological testosterone levels.</strong></em></p><p></p><p>[ATTACH=full]42276[/ATTACH]</p><p></p><p><strong>Methods</strong></p><p></p><p><em>We identified patients with hypogonadism (<300 ng/dL) who underwent testosterone replacement therapy (TRT) at our institution through electronic medical record review. Patients lacking records of their first encounter, documented medical history, sufficient follow-up, or post-TRT adverse event data were excluded from the analysis. <strong>Supraphysiological testosterone levels were defined as >1000 ng/dL. The included patients were retrospectively analyzed using two-way nonparametric testing for continuous variables and chi-square and Fisher exact tests for categorical variables (α = 0.05).</strong></em></p><p></p><p></p><p><strong>Results</strong></p><p></p><p><em>From a cohort of 537 men diagnosed with hypogonadism, <strong>we included 184 patients who underwent testosterone replacement therapy (TRT). Among these patients, 135 (73.4%) were treated to achieve physiological testosterone levels, with a median level of 468.0 ng/dL (interquartile range, IQR = 308.0-644.5), while 49 patients (26.6%) were treated to attain supraphysiologic testosterone levels, with a median level of 1552 ng/dL (IQR = 1279-1700).</strong> Before initiating TRT, there was no significant difference in testosterone levels between the two groups (p = 0.11). Moreover, no significant differences were found between the groups in terms of a history of diabetes mellitus (DM; p = 0.422) or prostate cancer (p = 0.29).<strong> However, significant differences were observed in the history of hypertension (HTN; p = 0.003) and hyperlipidemia (HLD; p = 0.006), with more patients in the physiologic testosterone group having a diagnosis of HTN and HLD prior to treatment.</strong> <strong>Regarding adverse events, there were more cases of polycythemia in the supraphysiologic testosterone group compared to the physiologic testosterone group (p < 0.001; 35.4% vs. 7.0%). Interestingly, there was no significant difference in the rate of other adverse events after TRT between the two groups, including venous thromboembolism (VTE; p = 0.285), major adverse cardiovascular events (MACE; p = 0.768), deep vein thrombosis (DVT; p > 0.999), myocardial infarction (MI; p = 0.562), and stroke (p > 0.999).</strong></em></p><p></p><p></p><p><strong>Conclusions</strong></p><p><strong></strong></p><p><strong><em>Despite widespread concerns, these findings suggest that <u>although patients treated to achieve supraphysiologic testosterone levels had a higher incidence of polycythemia, there were no significant differences in the rates of other adverse events after TRT between patients treated to attain physiological versus supraphysiologic testosterone levels</u>.</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 275937, member: 13851"] [URL unfurl="true"]https://academic.oup.com/jsm/article/21/Supplement_1/qdae001.084/7600775[/URL] [B]Abstract Introduction[/B] [I]Sustained treatment with elevated levels of exogenous testosterone (T) has been linked to various adverse events, particularly concerning cardiovascular risks.[B] However, there is currently a lack of sufficient literature that comprehensively describes the overall safety profile of supraphysiologic testosterone levels.[/B][/I] [B]Objective[/B] [I]To compare the safety profiles and rates of polycythemia, venous thromboembolism (VTE), major adverse cardiac events (MACE), deep vein thrombosis (DVT), myocardial infarction (MI), and stroke [B]between hypogonadism patients treated with testosterone replacement therapy (TRT) at physiological and supraphysiological testosterone levels.[/B][/I] [ATTACH type="full" alt="heartattackstroke.jpg"]42276[/ATTACH] [B]Methods[/B] [I]We identified patients with hypogonadism (<300 ng/dL) who underwent testosterone replacement therapy (TRT) at our institution through electronic medical record review. Patients lacking records of their first encounter, documented medical history, sufficient follow-up, or post-TRT adverse event data were excluded from the analysis. [B]Supraphysiological testosterone levels were defined as >1000 ng/dL. The included patients were retrospectively analyzed using two-way nonparametric testing for continuous variables and chi-square and Fisher exact tests for categorical variables (α = 0.05).[/B][/I] [B]Results[/B] [I]From a cohort of 537 men diagnosed with hypogonadism, [B]we included 184 patients who underwent testosterone replacement therapy (TRT). Among these patients, 135 (73.4%) were treated to achieve physiological testosterone levels, with a median level of 468.0 ng/dL (interquartile range, IQR = 308.0-644.5), while 49 patients (26.6%) were treated to attain supraphysiologic testosterone levels, with a median level of 1552 ng/dL (IQR = 1279-1700).[/B] Before initiating TRT, there was no significant difference in testosterone levels between the two groups (p = 0.11). Moreover, no significant differences were found between the groups in terms of a history of diabetes mellitus (DM; p = 0.422) or prostate cancer (p = 0.29).[B] However, significant differences were observed in the history of hypertension (HTN; p = 0.003) and hyperlipidemia (HLD; p = 0.006), with more patients in the physiologic testosterone group having a diagnosis of HTN and HLD prior to treatment.[/B] [B]Regarding adverse events, there were more cases of polycythemia in the supraphysiologic testosterone group compared to the physiologic testosterone group (p < 0.001; 35.4% vs. 7.0%). Interestingly, there was no significant difference in the rate of other adverse events after TRT between the two groups, including venous thromboembolism (VTE; p = 0.285), major adverse cardiovascular events (MACE; p = 0.768), deep vein thrombosis (DVT; p > 0.999), myocardial infarction (MI; p = 0.562), and stroke (p > 0.999).[/B][/I] [B]Conclusions [I]Despite widespread concerns, these findings suggest that [U]although patients treated to achieve supraphysiologic testosterone levels had a higher incidence of polycythemia, there were no significant differences in the rates of other adverse events after TRT between patients treated to attain physiological versus supraphysiologic testosterone levels[/U].[/I][/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Impact of TRT on Adverse Cardiovascular Events in Men with Low Testostosterone: Evaluation of Physiological and Supraphysiological T Levels
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