The influence of testosterone on the risk of cardiovascular events after percutaneous coronary intervention

Cheng-Hung Chiang; Wan-Ting Hung; En-Shao Liu; Tse-Hsuan Yang; Chin-Chang Cheng; Wei-Chun Huang; Guang-Yuan Mar; Feng-Yu Kuo

doi:10.3389/fcvm.2022.998056

The influence of testosterone on the risk of cardiovascular events after percutaneous coronary intervention

Front Cardiovasc Med. 2022 Dec 22:9:998056. doi: 10.3389/fcvm.2022.998056. eCollection 2022.

Authors

Cheng-Hung Chiang^{1

2}, Wan-Ting Hung³, En-Shao Liu¹, Tse-Hsuan Yang¹, Chin-Chang Cheng^{1

2}, Wei-Chun Huang^{2

3

4

5}, Guang-Yuan Mar¹, Feng-Yu Kuo^{1

6}

Affiliations

¹ Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
² College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁴ Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
⁵ Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan.

Abstract

Methods: Between 2015 and 2018, 580 men undergoing PCI at a tertiary referral hospital were divided into low (<3.25 ng/mL) and normal (≥3.25 ng/mL) testosterone groups. Major adverse cardiovascular event (MACE) was defined as the composite outcome of CV death, myocardial infarction, and target lesion revascularization/target vessel revascularization (TLR/TVR) during up to 48 months follow-up after PCI.

Results: There were 111 and 469 patients in the low and normal testosterone groups, respectively, with the overall MACE rate of the former being higher than the latter (26.13% vs. 13.01%, p = 0.0006). Moreover, the overall TLR/TVR (20.72% vs. 11.73%, p = 0.0125) and myocardial infarction (3.6% vs. 0.85%, p = 0.0255) rates were significantly higher in those with low serum testosterone who also had a shorter average event-free survival analysis of MACE (25.22 ± 0.88 months) than those with normal testosterone levels (35.09 ± 0.47 months, log-rank p = 0.0004). Multiple logistic regression demonstrated an association between low serum testosterone (<3.25 ng/mL) and a higher MACE rate [odds ratio: 2.06, 95% confidence interval (CI) 1.21-3.51, p = 0.0081]. After adjusting for variables in a Cox regression model, hazard ratios (HRs) for MACE (HR: 1.88, 95% CI: 1.20-2.95, p = 0.0058) and TLR/TVR (HR: 1.73, 95% CI: 1.06-2.83, p = 0.0290) rates were higher in the low testosterone group than those in the normal testosterone group.

Conclusion: Low serum testosterone concentrations were associated with a higher risk of MACE and TLR/TVR after PCI than those with normal testosterone levels.

Keywords: EPI—epidemiology; coronary artery disease; major adverse cardiovascular events; percutaneous coronary intervention; testosterone.