Objective: Testosterone levels play a role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. Materials and methods: Our cohort included 802 adult subjects, from 40 to 80 years. Patients were excluded if they had a past history of peripheral or coronary artery disease, and revascularization. A blood sample was drawn to valuate testosterone level, and we considered normal testosterone levels 300 ng/dl. FMD (flow mediated dilatation) of the brachial artery was assessed by measuring the increase of the brachial artery diameter during reactive hyperemia after transient forearm ischemia. B-mode longitudinal images of the brachial artery were obtained at the level of the antecubital fossa. The FMD was defined as the percentage change in the brachial artery diameter 60 s after releasing the ischemic cuff. Erectile dysfunction (ERD) was assessed by the International Index of Erectile Function-5 (IIEF-5) score questionnaire. We considered composite end points including the following major adverse cardiovascular events (MACEs) Results: Subjects with lower serum testosterone levels (n = 332) had higher prevalence of traditional cardiovascular risk factors, such as hypertension (p = 0.009), diabetes (p = 0.03), dyslipidemia (p < 0.0001), obesity (p = 0.002), and endothelial function score (p < 0.0001). AMI, death after AMI, major stroke and all clinical events were more frequent (p < 0.001) in patients with testosterone levels < 300 ng/dl. Further, by multiple logistic regression analysis we found that only dyslipidemia (p = 0,001), obesity (p = 0,007), testosterone < 300 ng/dl (p < 0,0001) and ED (p < 0,0001) were independent predictors of future events. Conclusions: A therapeutic intervention on testosterone may not only have a positive effect on the cardiovascular system but also an important role in preventing new cardiovascular events.KEY WORDS: Erectile dysfunction; Cardiovascular events; Prevention. gy (1). In particular, in the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. We aimed to assess whether baseline testosterone levels may be predictors of future cardiovascular events in a cohort of intermediate cardiovascular risk patients, according to Framingham risk score, and screened for the presence of ED in our Centre of Early Diagnosis of Preclinical and Multifocal Atherosclerosis and for Cardiovascular Prevention. The follow-up period was 5 years. We therefore aimed to test the hypothesis that measuring levels of this hormone, can provide information not only on the progression of atherosclerosis disease and therefore about ED, helping to define the prognosis, but can also be considered predictive of the risk of developing cardiovascular events, independently from common risk factors.
MATERIALS AND METHODSOur cohort included 802 adult subjects, males from 40 to 80 years (mean age of the whole population was 57.52 ± 13.85 y...