替代疗法和血管血栓栓塞事件:一个系统的审查和元分析
Rossella Cannarella1,2, Carmelo Gusmano1, Claudia Leanza1
1Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.
Asian journal of andrology
|November 3, 2023
概括
替代疗法 (TRT) 没有增加低的男性的动脉或静脉血栓形成风险. 随机试验表明TRT对心血管事件是安全的,但需要更多关于深静脉血栓的数据.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 血栓形成研究研究
背景情况:
- 低阴性腺症的特征是总体丸激素 (TT) 低,影响了许多男性.
- 替代疗法 (TRT) 用于治疗低性恋症.
- 对TRT的心血管安全性,特别是对血栓形成风险的安全性,需要进行彻底的评估.
研究的目的:
- 评估TRT和动脉和/或静脉血栓形成之间的关联在前治疗TT <12nmol/L的男性中.
- 综合随机对照试验 (RCT) 和对TRT和血栓事件的观察性研究的证据.
主要方法:
- 使用人口干预比较结果 (PICO) 模型进行了元分析.
- 包括对男性TT<12nmol/L或被诊断为阴性双胞胎症的研究,将TRT与安慰剂或没有治疗进行比较.
- 分析的结果包括动脉血栓事件 (中风,心肌梗塞),静脉血栓栓塞 (VTE) 和死亡率.
主要成果:
- 根据RCT数据 (4027名患者),TRT并没有显著改变动脉血栓形成,中风,心肌梗塞,静脉动脉突发症,肺栓塞或死亡的风险.
- 观察性研究 (310,288名患者) 表明,TRT治疗降低了动脉血栓事件,MI,VTE和死亡率的风险.
- 由于RCT数据有限,深静脉血栓症 (DVT) 的风险仍然不确定.
结论:
- 在TT<12nmol/L的男性中,TRT似乎对主要不良心血管事件是安全的.
- 需要进一步的研究,专门调查接受TRT的男性的DVT风险.
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