November 11th, 2013
Selections from Richard Lehman’s Literature Review: November 11th
CardioExchange is pleased to reprint this selection from Dr. Richard Lehman’s weekly journal review blog at BMJ.com. Selected summaries are relevant to our audience, but we encourage members to engage with the entire blog.
JAMA 6 Nov 2013 Vol 310
Association of Testosterone Therapy With Mortality, MI, and Stroke in Men With Low Testosterone Levels (pg. 1829): Testosterone is the root of all evil, according to some. Or else it is the essence of manly life. Both, probably. You can find any number of websites touting the benefits of testosterone replacement therapy and there is an active “low T” advertising campaign in the USA. It is a relatively evidence-free area, and in my view it remains so after this study, which compared outcomes in men with low testosterone and coronary heart disease who were given testosterone to outcomes in the majority who were not. The authors looked at 8709 US Armed Forces veterans who presented for coronary angiography and happened to have had their testosterone measured and found to be lower than 300 ng/dL (about 11 nmol/L). Of these, 1223 started testosterone therapy after a median of 531 days following coronary angiography. At a mean follow-up of three years, these men had a higher rate of death, myocardial infarction, and stroke. But there is simply no way to adjust for all possible dissimilarities between these groups.