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It's a question that many men anxiously ask their doctor: "Will a TRT protocol cause heart disease?" A great deal of mis-information has provoked articles in the popular press that raise all sorts of concerns, despite that fact that a number of studies have shown that testosterone is safe and not a factor in cardiac-related events. A new report appeared in the Asian Journal of Urology, "Testosterone Treatment and Cardiovascular Events in Prescription Database Studies," September 2017, concluded "T treatment was not associated with increased risks for thrombosis, MI, stroke, composite CV events, or mortality."
The paper reviewed retrospective/observational studies using prescription databases to the examine the association of testosterone treatment with the above-referenced morbidities. A literature search yielded eligible studies that were either retrospective cohort or case-control studies analyzing prescription or insurance claim databases. Fourteen studies were examined.
Summary of Results by Specific Outcomes
In three studies of stroke, "T treatment was not associated with an increased risk of stroke." The same study referenced in the MI results section (above) reported a 36% decreased risk for stroke with T treatment.
Three studies reported conflicting results on the association of T treatment and composite CV outcomes. However, at least one of those studies was poorly designed.
Four studies indicated that treatment with testosterone was not associated with an elevated risk for thrombosis. One study indicated an increased risk of such an event.
No study found an overall increased mortality risk for men being treated with testosterone. The decreased mortality risk (all-cause mortality) ranged from 22%-66%.
Conclusion
The studies examined over 215,000 men being treated with testosterone. Most, by a substantial majority, showed that such treatment was not associated with cardiovascular disease/mortality. However, the author points out that - given the nature and limitations of retrospective, observational data - discussion and debate will likely continue until a large, prospective randomized, double-blind, placebo-controlled study is undertaken.
The abstract for this article is linked below. For a short time the full-text will also be available.
http://www.ajandrology.com/preprintarticle.asp?id=212903;type=0
The paper reviewed retrospective/observational studies using prescription databases to the examine the association of testosterone treatment with the above-referenced morbidities. A literature search yielded eligible studies that were either retrospective cohort or case-control studies analyzing prescription or insurance claim databases. Fourteen studies were examined.
Summary of Results by Specific Outcomes
- MI (Myocardial Infarction):
- Stroke
In three studies of stroke, "T treatment was not associated with an increased risk of stroke." The same study referenced in the MI results section (above) reported a 36% decreased risk for stroke with T treatment.
- Composite CV Outcomes
Three studies reported conflicting results on the association of T treatment and composite CV outcomes. However, at least one of those studies was poorly designed.
- Thrombosis
Four studies indicated that treatment with testosterone was not associated with an elevated risk for thrombosis. One study indicated an increased risk of such an event.
- Mortality
No study found an overall increased mortality risk for men being treated with testosterone. The decreased mortality risk (all-cause mortality) ranged from 22%-66%.
Conclusion
The studies examined over 215,000 men being treated with testosterone. Most, by a substantial majority, showed that such treatment was not associated with cardiovascular disease/mortality. However, the author points out that - given the nature and limitations of retrospective, observational data - discussion and debate will likely continue until a large, prospective randomized, double-blind, placebo-controlled study is undertaken.
The abstract for this article is linked below. For a short time the full-text will also be available.
http://www.ajandrology.com/preprintarticle.asp?id=212903;type=0
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