Abstract 9690: Does Testosterone Therapy Increase Risk of Cardiovascular Event Among Men? A Meta-Analysis
Background: Testosterone therapy has been increasingly promoted and prescribed over the past decade. However, there is rising concern about its safety, and randomized data adequately powered to assess its effect on cardiovascular outcomes is not available.
Aim: We conducted a meta-analysis and systematic review of published randomized and observational studies to examine the overall risk of cardiovascular events associated with testosterone therapy.
Methods: We searched Medline (1966-2014), Embase (1966-2014), and Cochrane central (2000-2014). Data was collected and analyzed using random and fixed effect model, as appropriate, with inverse variance weighting.
Results: Of 2,800 studies identified, 34 were eligible including 76,270 patients with a mean follow up of 11.7 months. Testosterone therapy was associated with increased risk of cardiovascular events (adjusted HR=1.41, 95% CI = 1.18-1.70, p<0.05), all-cause mortality (adjusted HR=1.51, 95% CI = 1.05-2.18, p<0.05), and ischemic heart disease (adjusted HR=1.32, 95% CI = 1.11-1.57, p<0.05), but not cerebrovascular events (adjusted HR=1.22, 95% CI = 0.98-1.53, p=0.08). Using meta-regression and sensitivity analyses to account for factors such as baseline cardiovascular disease, timing of testosterone collection, and industry funding did not change the results of our main analysis.
Conclusions: Our meta-analysis demonstrates that testosterone therapy may be associated with increased risk of all-cause mortality, cardiovascular events, and ischemic heart disease.
Author Disclosures: N. makki: None. W. Karrowni: None. W. Karrowni: None.
- © 2014 by American Heart Association, Inc.