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Effect of Testosterone Level on Mortality in Patients With Left Ventricular Assist Device
Evrim Simsek1, Salih Kilic2, Hatice Soner Kemal3
1Ege University Faculty of Medicine, Department of Cardiology, Izmir, Turkey.
Insights
Low total testosterone (TT) and free testosterone (FT) levels are linked to increased mortality risk in patients receiving a Left Ventricular Assist Device (LVAD). This study highlights testosterone
Area of Science:
- Cardiology
- Endocrinology
- Medical Research
Background:
- Testosterone deficiency is a known mortality risk factor in heart failure patients.
- The impact of testosterone levels on outcomes after Left Ventricular Assist Device (LVAD) implantation remains unclear.
Purpose of the Study:
- To investigate the association between total testosterone (TT) and free testosterone (FT) levels and mortality in patients undergoing LVAD implantation.
Main Methods:
- Retrospective analysis of 101 male patients who underwent LVAD implantation between December 2010 and December 2014.
- Preoperative plasma measurements of TT and FT were analyzed alongside demographic, follow-up, and mortality data.
Main Results:
- A significant proportion of patients (31.6% for TT, 65.3% for FT) had below-normal testosterone levels.
- Low TT and FT levels were independently associated with increased mortality risk (HR 3.680 and 3.816, respectively) after adjusting for clinical variables.
- Cumulative survival rates were significantly worse for patients with low TT and FT compared to those with normal levels (P < .001 and P = .029).
Conclusions:
- Low total testosterone and free testosterone levels are independent risk factors for mortality in patients with LVAD.
- These findings suggest that testosterone levels should be considered in the management of LVAD patients.
Background And Objectives:
Testosterone deficiency is associated with mortality in patients with heart failure; however, its effects on patients undergoing Left Ventricular Assist Device (LVAD) implantation are unclear. We investigated the role of total testosterone (TT) and free testosterone (FT) levels on mortality undergoing LVAD implantation.
Methods:
Between December 2010 and December 2014, 101 consecutive male patients who underwent LVAD implantation and had plasma testosterone measurement (TT and FT) in the last month before operation were included in the study. Demographics, follow-up, and mortality data were analyzed retrospectively.
Results:
The mean age of the patients was 51.7 ± 11 years. TT and FT levels were in the below normal range of 31.6% (n = 32) and 65.3% (n = 66) of the patients, respectively. The mean follow-up time was 355 ± 268 days, and 32 (31%) patients died during follow-up. Cumulative survival rates were significantly worse in patients with low TT and FT than patients in the normal range (P < .001 and P = .029, respectively). Multivariate analysis after adjustment for clinical variables, age, albumin, C-reactive protein, total cholesterol, chronic kidney disease, diabetes mellitus (DM), and leukocytosis showed that low TT and FT were independently associated with poor survival (HR, 3.680; 95% CI, 1.615-8.385 P = .002 and HR, 3.816; 95% CI, 1.279-11.383, P = .016, respectively).
Conclusion:
Low TT and FT levels were independent risk factors for mortality in patients with LVAD.
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