Endocrine Abstracts

Background. Males with coronary disease have lower levels of endogenous testosterone than unaffected males. It is not known if low testosterone is a cause, effect or an epi-phenomenon of ischaemic heart disease.We hypothesised that androgen deficient men treated surgically with complete resolution of their symptoms would have a higher subsequent testosterone than men with persistent angina.
Methods. Subjects were recruited after angiography. All subjects were biochemically hypogonadal. Patients were reviewed (12 months later) for repeat blood tests and interview. Eight had undergone CABG surgery and had no angina. This group was compared to seven men who still had significant symptoms (assessed with exercise testing) despite medical therapy or angioplasty. The bio-available testosterone (nanomoles per litre) was compared at baseline and after 12 months (paired t-tests). The change in testosterone from baseline to 12 months was compared between groups by analysis of the delta values (unpaired t-test).
Results. The baseline testosterone in the surgical group and symptomatic group were not significantly different ( 2.1 plusminus 0.17 versus 2.3 plusminus 0.34: p=0.64). After an average of 12 months the testosterone in the surgical group had fallen significantly to (1.73 plusminus 0.18: p<0.05). The testosterone in the symptomatic group also fell to (1.82 plus minus 0.35) this reduction was not significant (p=0.173). Analysis of the change in bio-available testosterone between each of the groups found no significant difference (-0.3 plusminus 0.2) for the surgical group and (-0.45 plusminus 0.3) for the non-surgical group (p=0.791).
Conclusions. The data do not support the hypothesis. Androgen deficiency observed with coronary disease is not improved by abolishing angina. In fact a significant reduction in testosterone levels was seen in the surgical group over the time period assessed. These results suggest that androgen deficiency associated with ischaemic heart disease is not merely the effect of chronic symptomatic disease.The relationship between testosterone and coronary disease in males is uncertain. Testosterone levels in affected males is lower than unaffected controls. Many chronic symptomatic diseases are characterised by low androgen levels; this abstract suggests that low androgen levels in coronary disease are not simply an effect of chronic symptoms.