Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Rajat S. Barua¹  Deepak Parashara¹  John A. Ambrose²  Kamal Gupta³  Buddhadeb Dawn³  Mukut Sharma⁴  Rishi Sharma⁴  Olurinde A. Oni⁴  Surineni Kamalakar⁴  Ram Sharma⁴  Guoqing Chen⁵  Vikas Singh⁶ 

[1] Division of Cardiovascular Medicine, Kansas City VA Medical Center, Kansas City, MO;Division of Cardiovascular Medicine, University of California San Francisco, Fresno, CA;Division of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS;Division of Cardiovascular Research, Kansas City VA Medical Center, Kansas City, MO;Division of Health Services Research, University of Kansas Medical Center, Kansas City, KS;Division of Neurology, Kansas City VA Medical Center, Kansas City, MO;

关键词: atrial fibrillation;    testosterone;    testosterone replacement therapy;   

DOI  :  10.1161/JAHA.116.004880

来源: DOAJ

【 摘 要 】

BackgroundAtrial fibrillation (AF) is the most common cardiac dysrhythmia associated with significant morbidity and mortality. Several small studies have reported that low serum total testosterone (TT) levels were associated with a higher incidence of AF. In contrast, it is also reported that anabolic steroid use is associated with an increase in the risk of AF. To date, no study has explored the effect of testosterone normalization on new incidence of AF after testosterone replacement therapy (TRT) in patients with low testosterone. Methods and ResultsUsing data from the Veterans Administrations Corporate Data Warehouse, we identified a national cohort of 76 639 veterans with low TT levels and divided them into 3 groups. Group 1 had TRT resulting in normalization of TT levels (normalized TRT), group 2 had TRT without normalization of TT levels (nonnormalized TRT), and group 3 did not receive TRT (no TRT). Propensity score–weighted stabilized inverse probability of treatment weighting Cox proportional hazard methods were used for analysis of the data from these groups to determine the association between post‐TRT levels of TT and the incidence of AF. Group 1 (40 856 patients, median age 66 years) had significantly lower risk of AF than group 2 (23 939 patients, median age 65 years; hazard ratio 0.90, 95% CI 0.81–0.99, P=0.0255) and group 3 (11 853 patients, median age 67 years; hazard ratio 0.79, 95% CI 0.70–0.89, P=0.0001). There was no statistical difference between groups 2 and 3 (hazard ratio 0.89, 95% CI 0.78– 1.0009, P=0.0675) in incidence of AF. ConclusionsThese novel results suggest that normalization of TT levels after TRT is associated with a significant decrease in the incidence of AF.

【 授权许可】

Unknown