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Ageing men on TRT suffer from greater cardiovascular risk

21 Oct 2019
Looking into 2018, Singapore has a few plans in mind to improve healthcare for the public, especially the elderly.

Testosterone replacement therapy (TRT) may come with an increased risk of cardiovascular events in ageing men with low testosterone levels, a new study has found.

Accessing the UK Clinical Practice Research Datalink, researchers investigated the role of TRT on clinical outcomes in 15,041 men (mean age, 60.4±9.6 years) with low testosterone levels and no evidence of hypogonadotropic or testicular disease. The primary outcome was a composite between ischaemic stroke/transient ischaemic attacks and myocardial infarction.

TRT was prescribed to 4,485 men on at least one occasion, most of whom used testosterone gels/creams (56.8 percent); 33.6 percent received TRT via injections.

Over 71,541 person-years of follow-up, 850 cases of the composite outcome were reported, resulting in a crude incidence rate of 1.19 (95 percent CI, 1.11–1.27) per 100 persons per year. Current TRT use increased the risk of the primary outcome by 21 percent (hazard ratio [HR], 1.21, 1.00–1.46).

In absolute terms, TRT use would account for an adjusted risk difference of 2.4 events per 1,000 persons per year.

Stratified analysis found that this risk peaked in the first 6 months to 2 years of continuous TRT use (HR, 1.35, 1.01–1.79) but tapered thereafter. The effect was also strongest among those aged 45–59 years (HR, 1.44, 1.07–1.92).

Notably, current use significantly reduced the risk of all-cause mortality (HR, 0.64, 0.52–0.78) relative to nonuse of TRT, while past use had the opposite effect (HR, 1.72, 1.21–2.45).

The principal results were robust to sensitivity analyses and remained consistent even after disaggregation according to TRT formulation.

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Most Read Articles
Stephen Padilla, 06 Aug 2020
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
06 Aug 2020
Sodium–glucose cotransporter-2 (SGLT-2) inhibitors increase the risk for diabetic ketoacidosis (DKA) by almost threefold, with molecule-specific analyses suggesting a class effect, according to a study.
Stephen Padilla, 3 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.