a Endocrinology Unit, Medical Department, Azienda-Usl Bologna , Maggiore-Bellaria Hospital , Bologna , Italy.
b Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences , University of Florence , Florence , Italy.
Expert Opin Drug Saf. 2019 Apr;18(4):321-332. doi: 10.1080/14740338.2019.1607290. Epub 2019 Apr 24.
The cardiovascular (CV) safety of testosterone replacement therapy (TRT) remains a crucial issue in the management of subjects with late-onset hypogonadism. The authors systematically reviewed and discussed the available evidence focusing our analysis on heart-related issues.
All the available data from prospective observational studies evaluating the role endogenous T levels on the risk of acute myocardial infarction (AMI) were collected and analyzed. In addition, the impact of TRT on heart-related diseases, as derived from pharmaco-epidemiological studies as well as from randomized placebo-controlled trials (RCTs), was also investigated.
Available evidence indicates that endogenous low T represents a risk factor of AMI incidence and its related mortality. TRT in hypogonadal patients is able to improve angina symptoms in subjects with ischemic heart diseases and exercise ability in patients with heart failure (HF). In addition, when prescribed according to the recommended dosage, TRT does not increase the risk of heart-related events.
睾酮替代疗法（TRT）的心血管（CV）安全性仍然是治疗迟发性性腺功能减退症患者的一个关键问题。作者系统地回顾和讨论了现有的证据，重点分析了与心脏相关的问题。
收集和分析了所有评估内源性 T 水平与急性心肌梗死（AMI）风险之间关系的前瞻性观察性研究的可用数据。此外，还研究了 TRT 对心脏病的影响，这些影响来自药物流行病学研究以及随机安慰剂对照试验（RCT）。
现有证据表明，内源性低 T 是 AMI 发病率及其相关死亡率的一个危险因素。在性腺功能减退症患者中，TRT 能够改善缺血性心脏病患者的心绞痛症状和心力衰竭（HF）患者的运动能力。此外，当按照推荐剂量使用时，TRT 不会增加与心脏相关的事件的风险。
