February 4th, 2014

I TOLD YOU SO….. Testosterone Therapy Prescription Linked to HEART ATTACKS

Testosterone Therapy Prescription Linked to Myocardial Infarction
February 3, 2014

Prescription testosterone therapy (TT) was associated with an increased risk of myocardial infarction (MI) in older men and in younger men with prior heart disease, a new study found.

The use of TT has been increasing rapidly among men in recent years. Although previous research has made an association between TT and cardiovascular outcomes, many questions still remain.

Researchers led by Dr. William Finkle, Consolidated Research, Inc., Los Angeles, California, examined whether TT increases the risk of acute nonfatal MI in older and younger men, and whether preexisting cardiac disease would impact the effect.
The cohort study compared 55,593 men who filled a prescription for TT with 167,279 men who filled a prescription for phosphodiesterase type 5 inhibitors (PDE5Is) sildenafil or tadalafil. The MI incidence rate was measured in the 90 days after receiving their new prescription and in the year before.

Researchers found that men aged 65 years and older had nearly double the rate of nonfatal MIs in the 90 days after receiving a prescription for TT. In addition, men under 65 years of age who had a previous history of heart disease experienced a two- to threefold increased risk of nonfatal MIs in the 90 days after receiving a prescription for TT compared with those without a previous history of heart disease. Dr. Finkle and colleagues found that in individuals aged 65 years and older, the rate ratio (RR) for MI was 2.19 in those with TT prescriptions and 1.15 in those with PDE5I prescriptions. It was also discovered that the RR for TT prescription increased with age (from 0.95 for those ˂55 years to 3.43 for those ≥75 years). This was not observed in those with PDE5I prescriptions. Finally, excess risk of MI in men under the age of 65 years was only observed in those with a prior history of heart disease. Men in this age group with TT prescriptions and a history of heart disease had an RR of 2.90 compared with 0.90 for those without a history of heart disease. Men in this age group with PDE5I prescriptions and a history of heart disease had an RR of 1.40 compared with 0.99 for those without a history of heart disease.

The authors note that their study findings, when considered along with prior research, support an association between TT and the risk of serious adverse cardiovascular events, such as nonfatal MI, in men. Additional trials are needed to assess the risks and benefits of TT, they said.

The study was funded by the National Cancer Institute and was published in PLoS ONE..