The prognostic value of testosterone in chronic coronary artety disease

Doctoral Dissertation uoadl:2819215 280 Read counter

Unit:
Τομέας Βασικών Επιστημών
Library of the School of Health Sciences
Deposit date:
2018-11-12
Year:
2018
Author:
Kotakos Christos
Dissertation committee:
Ευστάθιος Ηλιοδρομίτης, Καθηγητής ,Ιατρική, ΕΚΠΑ
Γεράσιμος Φιλιππάτος, Καθηγητής ,Ιατρική, ΕΚΠΑ
Δημήτριος Αλεξόπουλος, Καθηγητής ,Ιατρική, ΕΚΠΑ
Λουκιανός Ραλλίδης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Χαράλαμπος Βλαχόπουλος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Σπυρίδων Δευτεραίος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ιωάννης Παρίσης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Η προγνωστική αξία της τεστοστερόνης στη χρόνια στεφανιαία νόσο
Languages:
Greek
Translated title:
The prognostic value of testosterone in chronic coronary artety disease
Summary:
Background: Low serum testosterone (T) levels are associated with increased all-cause mortality in community-based studies while there are no data on the prognostic role of free T (FT), the most active fraction of total T, in patients with coronary artery disease (CAD).
Objectives: We tested the hypothesis that endogenous FT predicts cardiovascular (CV) mortality in men with stable CAD.
Methods: Serum FT, lipids, high-sensitivity C-reactive protein (hsCRP) and intereukin-6 levels were measured in 612 consecutive men with stable CAD. Primary endpoint was CV death, and secondary endpoint hospitalizations for acute coronary syndrome, ventricular arrhythmias, or ischemic stroke.
Results: During a median follow-up of 5 years, 243 CV events (39.7%) occurred. Of these, 68 were CV deaths (11%), 140 acute coronary syndromes (22.9%), 7 strokes (1.1%), and 28 (4.6%) arrhythmic events. FT was inversely associated with CV death after adjustment for conventional risk factors for CAD (hazard ratio [HR]: 0.853; 95% confidence interval [CI]: 0.782 to 0.930; p<0.001). Further adjustment for ejection fraction of left ventricle or hsCRP did not change the association. Patients in the lowest tertile of FT (≤7 pg/mL) had 2,8 times higher risk of CV death compared to patients in the middle and highest tertile of FT (>7 pg/mL) after adjustment for traditional risk factors for CAD (HR: 2.815; 95% CI: 1.428 to 5.550; p=0.003). FT levels could not predict secondary endpoints (HR: 0.965; 95% CI: 0.920 to 1.013; p=0.151).
Conclusions: In order to explore whether endogenous free testosterone (FT) predicts cardiovascular (CV) mortality in men with stable coronary artery disease (CAD) we recruited 612 coronary men. During a 5 years follow-up, 68 CV deaths occurred.
FT was inversely associated with CV death after adjustment for classical risk factors (p<0.001). Patients in the lowest tertile of FT had 2.8 times higher risk of CV death compared to patients in the middle and highest tertile of FT, after adjustment for traditional risk factors. In conclusion, low FT levels are associated with high 5-year CV mortality in men with stable CAD, independently of other traditional CV risk factors.
Main subject category:
Health Sciences
Keywords:
Testosterone, Chronic coronary disease, Cardiovascular mortality
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
272
Number of pages:
133
KOTAKOS CHRISTOS PHD.pdf (1 MB) Open in new window