The Risk of Myocardial Infarction 10 or More Years After Vasectomy in Men Under 55 Years of Age1

Abstract

To evaluate whether vasectomy is associated with a subsequent increase in the incidence of myocardial infarction 10 or more years after surgery and whether an effect is more pronounced in those already predisposed to a myocardial infarction, a hospital-based case-control study was carried out in men aged less than 55 years. The men were interviewed during 1980-1983 in 78 hospitals in Massachusetts, Rhode Island, Connecticut, and New York. Among 2,238 men with first episodes of myocardial infarction, 332 (15%) had undergone vasectomy, compared with 572 (16%) of 3,361 controls. Vasectomy greater than or equal to 10 years earlier was reported by 150 cases and 180 controls, to yield a multivariate relative risk estimate of 1.0 after allowance for potential confounding factors (95% confidence interval (Cl) = 0.8-1.3); for vasectomy greater than or equal to 15 years before, based on 34 cases and 33 controls, the estimate was 1.1 (95% Cl = 0.7-2.0). In men predisposed to myocardial infarction because of more advanced age, cigarette smoking, elevated cholesterol level, hypertension, angina pectoris, or other risk factors, vasectomy did not appear to increase the risk further, even after intervals of greater than or equal to 10 years. The results provide evidence against an increased risk of myocardial infarction greater than or equal to 10 years after vasectomy overall and in those known to be predisposed because of other risk factors.

Low-Dose Oral Contraceptive Use and the Risk of Myocardial Infarction

“…We found previously that information obtained in our case-control studies by in-person and telephone interviews was relatively similar, as were the results. 11,12 In this study patients interviewed in the hospital were shown pictures of OC pills and packets to aid recall; patients interviewed at home by telephone were not. For 104 women who reported current OC use (ie, in the month before admission), who were willing for us to contact the prescribing physician, and whose physician responded, we compared self-report of current OC use and the product used with the report of the physician.…”

Vasectomy and cardiovascular disease risk

“…Table 1 displays the basic characteristics of the 12 included studies. Moreover, 2 were cross-sectional, [ 19 , 25 ] 4 were case–control, [ 17 , 18 , 21 , 26 ] and 6 were retrospective cohort studies. [ 20 , 22 – 24 , 27 , 28 ] The publication years of the included studies ranged from 1981 to 2005.…”

“…[ 20 , 22 – 24 , 27 , 28 ] The publication years of the included studies ranged from 1981 to 2005. Among them, seven were conducted in the United States, [ 19 , 20 , 23 – 26 , 28 ] 1 in China, [ 27 ] 2 in England, [ 21 , 22 ] and 2 in Korea. [ 17 , 18 ] Furthermore, 6 studies were performed among the middle-aged and elderly populations, [ 17 – 24 , 26 – 28 ] but one study did not report this.…”

“…In addition, 9 studies were considered to have high methodological quality, [ 17 , 18 , 20 , 22 – 24 , 26 – 28 ] and 3 studies [ 19 , 21 , 25 ] were regarded to be of poor quality in accordance with the NOS. The main deficiency was selection bias related to insufficient adjustment of core factors among the included studies.…”

Vasectomy: Morphological and immunological effects

“…T h e future of vasectomy seems assured, however, by several papers indicating no increase in autoimmune diseases (Mathews et al,1976;Bullock et al, 1977), blood coagulation disorders (Kisker et al, 1979), or ischemic heart disease (Goldacre et al, 1983;Petitti et al, 1983;Walker et al, 1983;Perrin et al, 1984;Rosenberg et al, 1986). Further work is required, however, to investigate suggestions that the peripheral rather than the coronary arteries might be affected (Campbell et al, 1983) and that vasectomy exacerbates arterial disease in diabetic monkeys (Bansal et al, 1986).…”