Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA.
Department of Internal Medicine, Crozer Chester Medical Center, Upland, PA, USA.
Prog Cardiovasc Dis. 2024 Jul-Aug;85:45-53. doi: 10.1016/j.pcad.2024.04.001. Epub 2024 Apr 7.
The Cardiovascular safety of testosterone replacement therapy (TRT) among men with hypogonadism is not well established to date. Hence, we sought to evaluate the cardiovascular disease (CVD) outcomes among patients receiving testosterone therapy by using all recently published randomized controlled trials.
We performed a systematic literature search on PubMed, EMBASE, and Clinicaltrial.gov for relevant randomized controlled trials (RCTs) from inception until September 30th, 2023.
A total of 30 randomized trials with 11,502 patients were included in the final analysis. The mean age was ranging from 61.61 to 61.82 years. Pooled analysis of primary and secondary outcomes showed that the incidence of any CVD events (OR, 1.12 (95%CI: 0.77-1.62), P = 0.55), stroke (OR, 1.01 (95%CI: 0.68-1.51), P = 0.94), myocardial infarction (OR, 1.05 (95%CI: 0.76-1.45), P = 0.77), all-cause mortality (OR, 0.94 (95%CI: 0.76-1.17), P = 0.57), and CVD mortality (OR, 0.87 (95%CI: 0.65-1.15), P = 0.31) was comparable between TRT and placebo groups.
Our analysis indicates that for patients with hypogonadism, testosterone replacement therapy does not increase the CVD risk and all-cause mortality.
目前为止，尚不确定雄性激素替代疗法（TRT）治疗性腺功能减退症男性的心血管安全性。因此，我们试图通过使用所有最近发表的随机对照试验来评估接受睾丸激素治疗的患者的心血管疾病（CVD）结局。
我们在 PubMed、EMBASE 和 Clinicaltrial.gov 上进行了系统的文献检索，以查找从开始到 2023 年 9 月 30 日的相关随机对照试验（RCT）。
共有 30 项随机试验，纳入了 11502 名患者，最终纳入了分析。平均年龄在 61.61 到 61.82 岁之间。主要和次要结局的汇总分析显示，任何 CVD 事件的发生率（OR，1.12（95%CI：0.77-1.62），P=0.55）、中风（OR，1.01（95%CI：0.68-1.51），P=0.94）、心肌梗死（OR，1.05（95%CI：0.76-1.45），P=0.77）、全因死亡率（OR，0.94（95%CI：0.76-1.17），P=0.57）和 CVD 死亡率（OR，0.87（95%CI：0.65-1.15），P=0.31）在 TRT 和安慰剂组之间无差异。
我们的分析表明，对于性腺功能减退症患者，睾丸激素替代疗法不会增加 CVD 风险和全因死亡率。
