001 Testosterone Replacement in Hypogonadal Men with Recent Coronary Artery Revascularization Improves Exercise Capacity

Abstract

Objectives: Current controversy regarding cardiovascular (CV) risk and testosterone replacement (TRT) exists. However, a robust scientific literature supports the fact that hypogonadism is a significant risk factor for CV disease (CVD). We sought to assess potential benefit of TRT in men with coronary artery disease (CAD) requiring revascularization in the past year. In this study we investigated the effect of TRT on exercise capacity and time to ischemic change on treadmill exercise testing. Methods: Fifty‐one subjects were enrolled in a randomized, double‐ blind, placebo‐controlled study: 31 in treatment (Androgel) group and 20 in placebo group. Chi‐squared analysis and t‐tests were performed to assess the ischemic changes (time to ST depression on stress test) and exercise time in seconds at month(s) 0, 1, 3, and 6. Results: In those with ischemic changes at baseline (n=21), we observed improvement in the exercise time in the treatment group at all‐time points: month 1 (589.7 vs 452.4), p=0.013, month 3 (607.6 vs 472.1), p=0.035, and month 6 (614.0 vs 470.0), p=0.087. Although there was improvement in time to ischemic change in the treatment group, it was not significant when compared to the placebo group. No serious adverse events (MI, stroke, death) occurred in either group. Conclusion: Exercise capacity is an independent prognostic factor for CVD and mortality. In this study, exercise time on treadmill was used as a measure of exercise capacity. Those in the treatment group showed a significant improvement in exercise capacity at month 1 and 3, indicating the beneficial role of TRT in men to improve CV health. These results support the role of TRT in hypogonadal men with stable CAD. (Figure Presented).