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Testosterone Therapy Adds MI Risk, Especially in Older Men — Physician’s First Watch

Medical News |
January 31, 2014

Testosterone Therapy Adds MI Risk, Especially in Older Men

By Joe Elia

Risk for incident myocardial infarction increases significantly in the months after starting testosterone therapy, particularly among older men, according to a PLoS ONE study.

Using insurance claims data, researchers compared the incidence of nonfatal MI in some 55,000 men in the year before their first prescription for testosterone therapy with the rate in the 90 days after filling that prescription. As a check, they also compared post- and pre-therapy MI rates for a separate cohort of 165,000 men taking drugs for erectile dysfunction.

In the testosterone cohort, the post-/pre-rate ratio for MI was 1.36, increasing to 2.19 in those 65 and older, and to 3.43 in those 75 and older. Younger men with a history of heart disease also showed an increased risk. The cohort taking sildenafil or tadalafil showed no post/pre effect.

The authors note that their study is limited in that they did not have information on the "serologic or diagnostic indications" for therapy. Nonetheless, they advise clinicians to include serious cardiovascular risks in their discussions with patients when prescribing testosterone.

Reader Comments (6)

leonard brancewicz RPh, NMd CCN Other Healthcare Professional, Preventive Medicine, private office

how can a study be released using insurance papers? what dose and form was used and for what period of time? what was the compliance level? were there other complicating factors afloat? other medications in place? strong conclusion with little facts!

JOHN JENNINGS Physician, Endocrinology, Retired

And what is the proposed mechanism for this acute effect of testosterone administration? This reminds me of the idiocy of the rosiglitazone-CV event fiasco perpetrated by Nissan et al where there was no plausible mechanism.

JC Other Healthcare Professional, Family Medicine/General Practice, multi specialty clinic

Wow, is this another study that is part of the new obamanization of medicine. Perhaps the conclusion should be that sildenafil and tadalafil are cardio-protective. Why do we do half accomplished studies? Oh, right its the money.

CORALYN FLAD Other, retired

This was put in the weekly roundup, but not elsewhere during the week. Please let us know which ones have their first appearance in the weekly roundup so we can pay more attention to them.

Salomon TCHUANDOM

No more results, methodology

JOSEPH FERMAGLICH Physician, Neurology

Very convincing

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