Adjuvant testosterone therapy in chronic heart failure (ATTIC): a randomised open-label trial

Area of Science:

• Cardiology
• Geriatrics
• Endocrinology

Background:

• Heart failure significantly impacts morbidity and mortality in the elderly.
• Current therapies offer limited benefits for geriatric heart failure patients.
• Testosterone therapy is an emerging treatment with potential benefits for cardiac function.

Purpose of the Study:

• To evaluate the efficacy of testosterone gel as an adjunct therapy for chronic stable heart failure in men over 60.
• To assess the impact of testosterone therapy on functional capacity, frailty, and quality of life.
• To determine the effects on cardiac remodeling and relevant biomarkers.

Main Methods:

• An open-label, randomized controlled trial involving 986 adult males aged 60+ with chronic stable heart failure.
• Participants received standard heart failure treatment, with the intervention group receiving additional testosterone gel.
• Assessments of functional capacity, frailty, quality of life, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were conducted at baseline and 12 weeks.

Main Results:

• Primary endpoints focus on changes in the 6-minute walk test, frailty index, and quality of life at 3 months.
• Secondary endpoints include changes in cardiac remodeling via echocardiography and NT-proBNP levels.
• Adverse drug reactions will also be monitored throughout the study.

Conclusions:

• Testosterone therapy presents a potential low-cost therapeutic option for improving outcomes in elderly heart failure patients.
• Further research is warranted to confirm the long-term benefits and safety profile.
• This trial aims to provide robust data on testosterone's role in managing geriatric heart failure.