Older men who were treated with intramuscular testosterone may not have an increased risk of myocardial infarction, and it may have a modestly protective effect for men at high risk, a study found.
Although it’s hardly the final word in the issue, the study states, so far, “Research on the effects of testosterone therapy on cardiovascular outcomes has yielded inconsistent results.” Meanwhile, prescriptions have risen 3-fold in the past decade, trials and meta-analysis have arrived at “broadly conflicting evidence,” and the Food and Drug Administration has required warning labels for the drug.
Researchers used a 5% national sample of Medicare beneficiaries to arrive at more than 6,300 patients treated with at least 1 injection of testosterone from January 1997 through December 2005 and matched the cohort to more than 19,000 patients who did not use testosterone. Patients were followed until December 31, 2005, or until they lost coverage from Medicare, enrolled in a health maintenance organization, experienced a MI, or died.
Results appeared in The Annals of Pharmacotherapy.
Testosterone therapy was not associated with an increased risk of MI (HR=0.84; 95% CI, 0.69 to 1.02). For men in the highest quartile of risk for a heart attack, testosterone therapy was associated with a reduced risk (HR=0.69; 95% CI, 0.53 to 0.92). There was no difference in risk for the first (HR=1.20; 95% CI, 0.88 to 1.67), second (HR=0.94; 95% CI, 0.69 to 1.30), and third quartiles (HR=0.78; 95% CI, 0.59 to 1.01).
The lead author of the study explains his findings: