All-cause Mortality and Mortality of Myocardial Infarction for 989 Legally Castrated Men

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Male gender is an independent coronary risk factor. Long-term follow-up of 989 Danish men who underwent legal castration between 1929 and 1968. The legally castrated men were unmarried and belonged to social class IV and V more often than were Danish men in general. During the follow-up until 2000, 835 of the 989 (85%) castrated men died, including 148 who died of myocardial infarction. In multiple Poisson regression analyses, the men had a standardized mortality rate (SMR) for all-cause mortality of 1.30 (95% CI: 1.26-1.36) and a SMR for mortality of myocardial infarction of 1.08 (95% CI: 1.04-1.16). Thus, the castrated men had a lower proportion of deaths of myocardial infarction (148/792, 18.7% (95% CI: 16.0-21.6%)) than was expected based on the mortality rates for the Danish male population (136/608, 22.4%). The castrated men had discordant changes for the SMR for all-cause mortality and mortality of myocardial infarction whereas subgroups of the Danish population previously has been found to have concordant changes for the two SMRs. The castrated men had fewer deaths of myocardial infarction than expected, so men may not have increased risk of coronary heart disease from unphysiologically low levels of endogenous androgens.