Recent testosterone drop-off and risk of cardiovascular events

Figures & data

Table 1. Characteristics of participants, by outcome status.

	Had CV events during study period (n = 79)		Did not have CV events during study period (n = 297)
Characteristics	Mean ± SD	Range	Mean ± SD	Range	p-Value^a
	N (%)		N (%)
Age at study entry (years)	63.49 ± 4.75	49-73	64.06 ± 4.66	45–74	0.3456
Baseline testosterone (nmol/L)	9.49 ± 1.22	5.89–12.13	9.75 ± 1.12	5.89–11.79	0.0941
BMI (kg/m^2)	31.86 ± 4.77	23.20–46.02	29.66 ± 3.94	22.15–46.98	0.0003
Smoker	42 (53.16)	–	96 (32.32)	–	0.001
Alcohol user	50 (63.29)	–	135 (45.45)	–	0.005
Hypertension	68 (86.08)	–	216 (72.73)	–	0.014
Diabetes	46 (58.23)	–	107 (36.03)	–	<0.001
Dyslipidemia	55 (69.62)	–	179 (60.27)	–	0.128
Family history of coronary heart disease	37 (46.84)	–	62 (20.88)	–	<0.001
Prior CV event before study entry	34 (43.04)	–	73 (24.58)	–	0.001
Follow-up (years)	7.82 ± 1.51	4–10	7.35 ± 1.79	2–11	0.0181

^ap-value for t-test if the variable is continuous; p-value for Chi-Square test if the variable is categorical.

CV: cardiovascular.

SD: standard deviation.

BMI: body mass index.

Table 2. Cox proportional hazards regression of cardiovascular events on testosterone drop, after adjustment, by prior cardiovascular event status.

	Without prior CV events (N = 269)			With prior CV events (N = 107)
	HR (95%CI)			HR (95%CI)
	Any CV event	MI	Stroke	Any CV Event	MI	Stroke
T drop (continuous)	1.00 (0.76, 1.29)	1.11 (0.81, 1.53)	1.07 (0.74, 1.56)	1.26 (0.96, 1.67)	1.14 (0.79, 1.66)	1.28 (0.88, 1.87)
T drop ≥ 1.39^a	1.33 (0.73, 2.43)	2.04 (0.99, 4.20)	1.05 (0.43, 2.53)	1.14 (0.59, 2.20)	0.95 (0.38, 2.37)	1.53 (0.66, 3.54)
T drop ≥ 2.08^b	1.21 (0.66, 2.23)	1.78 (0.86, 3.67)	1.05 (0.43, 2.54)	1.30 (0.67, 2.45)	1.05 (0.42, 2.64)	1.76 (0.76, 4.04)
T drop ≥ 3.12^c	1.34 (0.66, 2.72)	2.06 (0.94, 4.52)	1.00 (0.33, 2.98)	2.72 (1.37, 5.41)	1.87 (0.69, 5.08)	3.01 (1.22, 7.40)

^a 50th percentile of testosterone drop (nmol/L).

^b 75th percentile of testosterone drop (nmol/L).

^c 90th percentile of testosterone drop (nmol/L).

CV: cardiovascular.

HR: hazard ratio.

CI: confidence interval.

MI: myocardial infarction.

Adjusting for age at study entry, BMI, smoking and drinking status, family history of coronary heart disease, and baseline comorbidity (hypertension, diabetes, dyslipidemia).

Table 3. Cox proportional hazards regression of cardiovascular events on testosterone drop, after adjustment.

Total (N = 376)
	HR (95%CI)
	Any CV event	MI	Stroke
T drop (continuous)	1.11 (0.93, 1.33)	1.09 (0.82, 1.47)	1.15 (0.90, 1.47)
T drop ≥ 1.39^a	1.29 (0.83, 2.00)	1.58 (0.90, 2.77)	1.29 (0.71, 2.36)
T drop ≥ 2.08^b	1.29 (0.83, 2.01)	1.52 (0.86, 2.67)	1.39 (0.76, 2.54)
T drop ≥ 3.12^c	1.93 (1.19, 3.11)	2.09 (1.14, 3.86)	1.71 (0.87, 3.33)

^a 50th percentile of testosterone drop (nmol/L).

^b 75th percentile of testosterone drop (nmol/L).

^c 90th percentile of testosterone drop (nmol/L).

CV: cardiovascular.

HR: hazard ratio.

CI: confidence interval.

MI: myocardial infarction.

Adjusting for age at study entry, BMI, smoking and drinking status, family history of coronary heart disease, and baseline comorbidity (hypertension, diabetes, dyslipidemia), and prior cardiovascular event status.

Figure 1. Mean testosterone levels over time, by outcome status.

Figure 2. Testosterone changes over time for selected patients who experienced CV events during the study period.

Figure 3. Testosterone changes over time for selected patients who did not experience CV events during the study period.