| アブストラクト | PURPOSE: We assessed the risk of ischemic stroke, transient ischemic attack, and myocardial infarction associated with testosterone replacement therapy (TRT) among aging men with low testosterone levels. METHODS: Using the UK Clinical Practice Research Datalink, we formed a cohort of men aged 45 years or older with low testosterone levels and no evidence of hypogonadotropic or testicular disease, between 1995 and 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) of a composite of ischemic stroke/transient ischemic attack and myocardial infarction were estimated using time-dependent Cox proportional hazards models, comparing current use of TRT with nonuse. RESULTS: The cohort included 15,401 men. During 71,541 person-years of follow-up, 850 patients experienced an ischemic stroke/transient ischemic attack/myocardial infarction (crude incidence rate 1.19 [95% confidence interval (CI), 1.11-1.27] per 100 persons per year). Compared with nonuse, current use of TRT was associated with an increased risk of the composite outcome (HR 1.21; 95% CI, 1.00-1.46). This risk was highest in the first 6 months to 2 years of continuous TRT use (HR 1.35; 95% CI, 1.01-1.79), as well as among men aged 45-59 years (HR 1.44; 95% CI, 1.07-1.92). CONCLUSIONS: TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2 years of use. In the absence of identifiable causes of hypogonadism, TRT should be initiated with caution among aging men with low testosterone levels. |
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| 投稿日 | 2019/4/7 |
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| 投稿者 | Loo, Simone Y; Azoulay, Laurent; Nie, Rui; Dell'Aniello, Sophie; Yu, Oriana Hoi Yun; Renoux, Christel |
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| ジャーナル名 | The American journal of medicine |
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| 組織名 | Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research,;Jewish General Hospital, Montreal, Quebec, Canada.;Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology,;Biostatistics, and Occupational Health, McGill University, Montreal, Quebec,;Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal,;Quebec, Canada.;Jewish General Hospital, Montreal, Quebec, Canada; Division of Endocrinology,;Canada; Department of Neurology and Neurosurgery, McGill University, Montreal,;Quebec, Canada. Electronic address: christel.renoux@mcgill.ca. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30953635/ |
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