Anne Wang1, Stefan Arver2, John Flanagan2, Viveca Gyberg1,3, Per Näsman4, Viveca Ritsinger1,5, Linda G Mellbin1,6. 1. 1 Division of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. 2. 2 Department of Medicine, Center for Andrology and Sexual Medicine, Karolinska Institutet, Huddinge, Sweden. 3. 3 Department of Neurobiology, Centre for Family Medicine, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. 4. 4 Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden. 5. 5 Department of Research and Development, Region Kronoberg, Växjö, Sweden. 6. 6 Heart & Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
Abstract
OBJECTIVE: Low testosterone has been associated with increased cardiovascular risk and glucose abnormalities. This study explored the prevalence of low testosterone, dynamics over time and prognostic implications in acute myocardial infarction patients with or without glucose abnormalities. METHODS: Male acute myocardial infarction patients (n = 123) and healthy controls (n = 124) were categorised as having normal or abnormal glucose tolerance (impaired glucose tolerance or diabetes) by oral glucose tolerance testing. Testosterone was measured at hospital admission, discharge, 3 and 12 months thereafter in patients. Patients and controls were followed for 11 years for major cardiovascular events (cardiovascular death/acute myocardial infarction/stroke/severe heart failure). RESULTS: At hospital admission, more patients had low testosterone (⩽300 ng/dl) and lower median levels than controls (64 vs 28%; p < 0.001 and 243 vs 380 ng/dl; p < 0.01). At the subsequent time points, testosterone had increased to 311, 345 and 357 ng/dl. Patients with abnormal glucose tolerance had the highest prevalence (75%) of low levels. In adjusted Cox regression models, neither total nor free testosterone predicted major cardiovascular events. CONCLUSION: Low testosterone levels were common in male acute myocardial infarction patients in the acute phase, especially in the presence of abnormal glucose tolerance, but increased over time indicating that testosterone measured in close proximity to acute myocardial infarction should be interpreted with caution.
OBJECTIVE: Low testosterone has been associated with increased cardiovascular risk and glucose abnormalities. This study explored the prevalence of low testosterone, dynamics over time and prognostic implications in acute myocardial infarctionpatients with or without glucose abnormalities. METHODS: Male acute myocardial infarctionpatients (n = 123) and healthy controls (n = 124) were categorised as having normal or abnormal glucose tolerance (impaired glucose tolerance or diabetes) by oral glucose tolerance testing. Testosterone was measured at hospital admission, discharge, 3 and 12 months thereafter in patients. Patients and controls were followed for 11 years for major cardiovascular events (cardiovascular death/acute myocardial infarction/stroke/severe heart failure). RESULTS: At hospital admission, more patients had low testosterone (⩽300 ng/dl) and lower median levels than controls (64 vs 28%; p < 0.001 and 243 vs 380 ng/dl; p < 0.01). At the subsequent time points, testosterone had increased to 311, 345 and 357 ng/dl. Patients with abnormal glucose tolerance had the highest prevalence (75%) of low levels. In adjusted Cox regression models, neither total nor free testosterone predicted major cardiovascular events. CONCLUSION: Low testosterone levels were common in male acute myocardial infarctionpatients in the acute phase, especially in the presence of abnormal glucose tolerance, but increased over time indicating that testosterone measured in close proximity to acute myocardial infarction should be interpreted with caution.