Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men

Authors

Alexander P. Cole, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Julian Hanske, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Wei Jiang, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Nicollette K. Kwon, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Stuart R. Lipsitz, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Martin Kathrins, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Peter A. Learn, University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD
Maxine Sun, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Adil H. Haider, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAFollow

Document Type

Article

Department

General Surgery

Abstract

Objectives: To assess the association of testosterone replacement therapy (TRT) with thromboembolism, cardiovascular disease (stroke, coronary artery disease and heart failure) and obstructive sleep apnoea (OSA).
Methods: A cohort of 3 422 male US military service members, retirees and their dependents, aged 40-64 years, was identified, who were prescribed TRT between 2006 and 2010 for low testosterone levels. The men in this cohort were matched on a 1:1 basis for age and comorbidities to men without a prescription for TRT. Event-free survival and rates of thromboembolism, cardiovascular events and OSA were compared between men using TRT and the control group, with a median follow-up of 17 months.
Results: There was no difference in event-free survival with regard to thromboembolism (P = 0.239). Relative to controls, men using TRT had improved cardiovascular event-free survival (P = 0.004), mainly as a result of lower incidence of coronary artery disease (P = 0.008). The risk of OSA was higher in TRT users (2-year risk 16.5% [95% confidence interval 15.1-18.1] in the TRT group vs 12.7% [11.4-14.1] in the control group.
Conclusions: This study adds to growing evidence that the cardiovascular risk associated with TRT may be lower than once feared. The elevated risk of OSA in men using TRT is noteworthy

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

BJU international

Recommended Citation

Cole, A. P., Hanske, J., Jiang, W., Kwon, N. K., Lipsitz, S. R., Kathrins, M., Learn, P. A., Sun, M., Haider, A. H. (2018). Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men. BJU international, 121(5), 811-818.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_gen/398