035 Improvement of Endothelial Function Following Initiation of Testosterone Replacement Therapy

Le résumé fourni par la source

Isolated recent studies have suggested an increased risk of heart attack as early as 3 months following testosterone replacement therapy (TRT) initiation. Such a rapid risk increase would likely require rapid deterioration of arterial endothelial function since atherosclerosis would be unlikely to develop so quickly de novo. Our goal was to assess arterial endothelial function in hypogonadal men prior to and at least 3 months after initiation of TRT. Adult men were consented for the study if they had symptoms of hypogonadism, a total testosterone <350 ng/dl, and planned to begin TRT. Endothelial function was non-invasively assessed using the Endo-PAT2000 machine, an FDA approved test of cardiac risk. We measured the Augmentation Index (AI) (normal < 3%), a measure of arterial stiffness and Reactive Hyperemia Index (RHI), a measure of endothelial vasodilation (normal > 1.69). Prior studies suggest that a 10% level of day to day test variability is expected. Topical gels or Testopel were used for TRT and target testosterone confirmed post therapy. Endothelial function was reassessed at the next clinic visit, between 3 and 6 months after treatment started if the patients were compliant with therapy. Changes in continuous variables were assessed with the paired t test and significance set at p<0.05

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