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

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

Cheng-Hung Chiang  1   2 , Wan-Ting Hung  3 , En-Shao Liu  1 , Tse-Hsuan Yang  1 , Chin-Chang Cheng  1   2 , Wei-Chun Huang  2   3   4   5 , Guang-Yuan Mar  1 , Feng-Yu Kuo  1   6
Affiliations

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

Cheng-Hung Chiang et al. Front Cardiovasc Med. .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier survival curve for MACE in male patients after PCI with low and normal testosterone level. The average survival time was 25.22 ± 0.88 months in low testosterone group (testosterone < 3.25 ng/mL) and 35.09 ± 0.47 months in normal testosterone group (testosterone ≥ 3.25 ng/mL). MACE, major adverse cardiovascular events. PCI, percutaneous coronary intervention.
FIGURE 2
FIGURE 2
Forest plots for multiple logistic regression including testosterone (≥3.25 ng/mL, as reference group), hypertension, diabetes mellitus, uremia, and CVA. CVA, cerebrovascular accident.
See this image and copyright information in PMC

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