Hypotestosteronemia is frequent in ST-elevation myocardial infarction patients and is associated with coronary microvascular obstruction

Niccoli, Giampaolo; Milardi, Domenico; D’Amario, Domenico; Fracassi, Francesco; Grande, Giuseppe; Panico, Roberta Antonazzo; Roberto, Marco; Mirizzi, A Mandurino; Canu, Giulia; Marinis, Laura De; Carrozza, Cinzia; Pontecorvi, Alfredo; Crea, Filippo

doi:10.1177/2047487314533084

Cited by 7 publications

(6 citation statements)

References 36 publications

(42 reference statements)

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“…18 However, several reports found that only free testosterone was significantly lower in men with coronary artery disease. 107 –110 It has also been shown that a low testosterone level was associated with atherosclerosis 111 and myocardial infarction 112 in men, supporting the previous findings that low levels of testosterone could increase the risk and contribute to a high prevalence of coronary artery disease in men. 22,110,113 –116 In addition, the level of testosterone shows an inverse correlation with the severity of coronary artery stenosis.…”

Section: Introductionsupporting

confidence: 61%

“…109 Men with MI 100 -Patients with STEMI and SA had low testosterone level -Hypotestosteronemia prevalence was higher among patients with STEMI compared with patients with SA -Hypotestosteronemia independently predicted both angio-MVO and ECG-MVO Testosterone deficiency may contribute to the development of coronary instability and MVO pathogenesis. 112 Men with CAD 111 -Plasma testosterone level was inversely correlated with the degree of coronary stenosis. -Higher blood level of TT was associated with the lower number of stenosis in the coronary arteries.…”

Section: Resultsmentioning

confidence: 98%

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Roles of Testosterone Replacement in Cardiac Ischemia–Reperfusion Injury

Pongkan¹,

Chattipakorn²

2015

J Cardiovasc Pharmacol Ther

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Testosterone is an anabolic steroid hormone, which is the major circulating androgen hormone in males. Testosterone levels decreasing below the normal physiological levels lead to a status known as androgen deficiency. Androgen deficiency has been shown to be a major risk factor in the development of several disorders, including obesity, metabolic syndrome, and ischemic heart disease. In the past decades, although several studies from animal models as well as clinical studies demonstrated that testosterone exerted cardioprotection, particularly during ischemia-reperfusion (I/R) injury, other preclinical and clinical studies have shown an inverse relationship between testosterone levels and cardioprotective effects. As a result, the effects of testosterone replacement on the heart remain controversial. In this review, reports regarding the roles of testosterone replacement in the heart following I/R injury are comprehensively summarized and discussed. At present, it may be concluded that chronic testosterone replacement at a physiological dose demonstrated cardioprotective effects, whereas acute testosterone replacement can cause adverse effects in the I/R heart.

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Section: Introductionsupporting

confidence: 61%

Section: Resultsmentioning

confidence: 98%

Roles of Testosterone Replacement in Cardiac Ischemia–Reperfusion Injury

Pongkan¹,

Chattipakorn²

2015

J Cardiovasc Pharmacol Ther

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“…Critical illnesses can cause decreased testosterone levels; therefore, HBV-ACLF itself may contribute to lower TT. Previous studies have reported the high incidence of testosterone de ciency among critically ill patients with condition such as myocardial infarction and acute respiratory failure [19][20] . New evidence indicates that lipopolysaccharide, which promotes the development of ACLF [21] , may initiate in ammation and result in impaired Leydig cell function thus reduce testosterone production in men [22] .…”

Section: Discussionmentioning

confidence: 99%

Lower Testosterone Levels Predict Increasing Severity and Worse Outcomes of Hepatitis B Virus-Related Acute-On-Chronic Liver Failure in Males

Huang¹,

Dong²,

Zhang³

et al. 2021

Preprint

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Background: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a serious liver disease with pathogenesis remaining unclear. This study aims to investigate the association between testosterone levels, stage (early, middle, or late, categorized according to clinical manifestation), severity scores, and clinical outcomes of HBV-ACLF. Methods: This single-center observational study involved 160 male patients with HBV-ACLF, 151 chronic hepatitis B patients without liver failure (CHB) and 106 healthy controls (HC). Morning blood samples were collected and androgen levels analyzed by chemi-bioluminescent immunoassay. Time to death or liver transplantation within 90 days comprised the primary composite outcome. Results: Serum levels of total testosterone (TT), free testosterone index (FTI), dehydroepiandrosterone sulfate and cortisol were significantly lower among HBV-ACLF than CHB and HC, while androstenedione was higher. Low TT, SHBG and FTI were associated with increased stage (of HBV-ACLF, ascites, and hepatic encephalopathy) and severity scores (Model for End-stage Liver Disease and Chinese Group on the Study of Severe Hepatitis B-ACLF scores). Low TT (<142.39 ng/dL) was a risk factor for both the composite outcome and for death alone within 90 days. Multivariate analysis revealed TT to be a predictor for the composite outcome independent of age, BMI, SHBG, FTI, cortisol, and androstenedione. Conclusion: Low serum testosterone is common among male patients with HBV-ACLF and predictive of increased severity and worse outcome of the disease and may play an important role in the progression of HBV-ACLF.

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“…Recently, Niccoli et al examined the link between hypotestosteronemia and coronary microvascular obstruction (MVO) in patients with STEMI and revealed a higher prevalence of hypotestosteronemia in patients with STEMI compared to those with stable angina as well as in STEMI patients with MVO after PCI suggesting the potential effect of testosterone deficiency in the pathogenesis of MVO [ 25 ]. In their study, lower levels of testosterone in STEMI patients was associated with reduced success rate of PPCI as mentioned by lower post PCI TIMI flow.…”

Section: Discussionmentioning

confidence: 99%

Association of admission testosterone level with ST-segment resolution in male patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Separham¹,

Ghaffari²,

Sohrabi³

et al. 2017

Basic Clin. Androl.

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BackgroundLow level of testosterone may be associated with cardiovascular diseases in men, as some evidence suggests a protective role for testosterone in cardiovascular system. Little is known about the possible role of serum testosterone in response to reperfusion therapy in ST-elevation myocardial infarction (STEMI) and its relationship with ST-segment recovery. The present study was conducted to evaluate the association of serum testosterone levels with ST-segment resolution following primary percutaneous coronary intervention (PPCI) in male patients with acute STEMI.MethodsForty-eight men (mean age 54.55 ± 12.20) with STEMI undergoing PPCI were enrolled prospectively. Single-lead ST segment resolution in the lead with maximum baseline ST-elevation was measured and patients were divided into two groups according to the degree of ST-segment resolution: complete (> or =50%) or incomplete (<50%). The basic and demographic data of all patients, their left ventricular ejection fraction (LVEF) and laboratory findings including serum levels of free testosterone and cardiac enzymes were recorded along with angiographic finding and baseline TIMI (Thrombolysis in Myocardial Infarction) flow and also in-hospital complications and then these variables were compared between two groups.ResultsA complete ST-resolution (≥50%) was observed in 72.9% of the patients. The serum levels of free testosterone (P = 0.04), peak cardiac troponin (P = 0.03) were significantly higher and hs-CRP (P = 0.02) were lower in patients with complete ST-resolution compared to those with incomplete ST-resolution. In-hospital complications were observed in 31.2% of patients. The patients with a lower baseline TIMI flow (P = 0.03) and those who developed complications (P = 0.04) had lower levels of free testosterone. A significant positive correlation was observed between the left ventricular function and serum levels of free testosterone (P = 0.01 and r = +0.362).ConclusionThis study suggests that in men with STEMI undergoing PPCI, higher serum levels of testosterone are associated with a better reperfusion response, fewer complications and a better left ventricular function.Electronic supplementary materialThe online version of this article (doi:10.1186/s12610-017-0058-7) contains supplementary material, which is available to authorized users.

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Hypotestosteronemia is frequent in ST-elevation myocardial infarction patients and is associated with coronary microvascular obstruction

Abstract: Our study shows higher prevelence of hypotestosteronemia among STEMI patients as compared with SA patients and among STEMI patients with MVO as compared with those without, thus suggesting a possible role of T deficiency in coronary instability and MVO pathogenesis.

Cited by 7 publications

References 36 publications

Roles of Testosterone Replacement in Cardiac Ischemia–Reperfusion Injury

Roles of Testosterone Replacement in Cardiac Ischemia–Reperfusion Injury

Lower Testosterone Levels Predict Increasing Severity and Worse Outcomes of Hepatitis B Virus-Related Acute-On-Chronic Liver Failure in Males

Association of admission testosterone level with ST-segment resolution in male patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

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