Abstract
BackgroundLow level of testosterone may be associated with cardiovascular diseases in men, as some evidence suggests a protective role for testosterone in cardiovascular system. Little is known about the possible role of serum testosterone in response to reperfusion therapy in ST-elevation myocardial infarction (STEMI) and its relationship with ST-segment recovery. The present study was conducted to evaluate the association of serum testosterone levels with ST-segment resolution following primary percutaneous coronary intervention (PPCI) in male patients with acute STEMI.MethodsForty-eight men (mean age 54.55 ± 12.20) with STEMI undergoing PPCI were enrolled prospectively. Single-lead ST segment resolution in the lead with maximum baseline ST-elevation was measured and patients were divided into two groups according to the degree of ST-segment resolution: complete (> or =50%) or incomplete (<50%). The basic and demographic data of all patients, their left ventricular ejection fraction (LVEF) and laboratory findings including serum levels of free testosterone and cardiac enzymes were recorded along with angiographic finding and baseline TIMI (Thrombolysis in Myocardial Infarction) flow and also in-hospital complications and then these variables were compared between two groups.ResultsA complete ST-resolution (≥50%) was observed in 72.9% of the patients. The serum levels of free testosterone (P = 0.04), peak cardiac troponin (P = 0.03) were significantly higher and hs-CRP (P = 0.02) were lower in patients with complete ST-resolution compared to those with incomplete ST-resolution. In-hospital complications were observed in 31.2% of patients. The patients with a lower baseline TIMI flow (P = 0.03) and those who developed complications (P = 0.04) had lower levels of free testosterone. A significant positive correlation was observed between the left ventricular function and serum levels of free testosterone (P = 0.01 and r = +0.362).ConclusionThis study suggests that in men with STEMI undergoing PPCI, higher serum levels of testosterone are associated with a better reperfusion response, fewer complications and a better left ventricular function.
Highlights
Low level of testosterone may be associated with cardiovascular diseases in men, as some evidence suggests a protective role for testosterone in cardiovascular system
Of the total of 50 eligible male patients who entered the study, two were excluded, including one patient requiring emergency CABG (Coronary Artery Bypass Graft surgery) and another who died before performing the primary percutaneous coronary intervention (PPCI), making for a total of 48 subjects
The main findings of the present study were as follows: 1) higher testosterone level was associated with better response to mechanical reperfusion in patients with ST-elevation myocardial infarction (STEMI) as manifested by complete ST-segment resolution; 2) higher testosterone level was associated with better baseline coronary Thrombolysis in Myocardial Infarction (TIMI) flow; 3) hypotestosteronemia was more frequent among patients with complicated STEMI; 4) better LV function
Summary
Low level of testosterone may be associated with cardiovascular diseases in men, as some evidence suggests a protective role for testosterone in cardiovascular system. Little is known about the possible role of serum testosterone in response to reperfusion therapy in ST-elevation myocardial infarction (STEMI) and its relationship with ST-segment recovery. The present study was conducted to evaluate the association of serum testosterone levels with ST-segment resolution following primary percutaneous coronary intervention (PPCI) in male patients with acute STEMI. The increased risk of cardiovascular events in aging male may be related to low serum testosterone levels and hypogonadism [1,2,3]. Low levels of testosterone have been associated with increased mortality in men with coronary artery disease (CAD) [6] and inverse relationship between endogenous testosterone and allcause mortality has been reported [7]. Men with low testosterone levels have frequently metabolic syndrome [8]
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