Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Not Associated With Reduced Myocardial...

Area of Science:

• Endocrinology
• Cardiovascular Health
• Smoking Cessation

Background:

• Testosterone replacement therapy (TRT) aims to restore testosterone levels in hypogonadal men.
• The impact of cigarette smoking (CS) on TRT outcomes, particularly cardiovascular health, remains an area of investigation.

Purpose of the Study:

• To investigate the combined effects of CS status and normalization of total testosterone (TT) levels post-TRT on all-cause mortality, myocardial infarction (MI), and stroke.
• To compare these outcomes in male smokers and non-smokers without prior cardiovascular events.

Main Methods:

• Analysis of data from 18,055 males receiving TRT, categorized by CS status and TT normalization.
• Utilized propensity score-weighted Cox proportional hazard models to assess combined effects.

Main Results:

• In non-smokers, normalized TT significantly decreased all-cause mortality and MI.
• In current smokers, normalized TT significantly decreased all-cause mortality but not MI.
• Current smokers with normalized TT had significantly higher risks of all-cause mortality, MI, and stroke compared to non-smokers with normalized TT.

Conclusions:

• Active cigarette smoking may counteract the cardiovascular benefits of testosterone level normalization achieved through TRT.
• TRT outcomes, particularly concerning mortality and MI, differ significantly between smokers and non-smokers.