Acute Anti-Ischemic Effect of Testosterone in Men With Coronary Artery Disease

Giuseppe M. C. Rosano, Filippo Leonardo, Paolo Pagnotta, Francesco Pelliccia, Gaia Panina, Elena Cerquetani, Paola Lilla della Monica, Bruno Bonfigli, Massimo Volpe, Sergio L. Chierchia
1999 Circulation  
Background-The role of testosterone on the development of coronary artery disease in men is controversial. The evidence that men have a greater incidence of coronary artery disease than women of a similar age suggests a possible causal role of testosterone. Conversely, recent studies have shown that the hormone improves endothelium-dependent relaxation of coronary arteries in men. Accordingly, the aim of the present study was to evaluate the effect of acute administration of testosterone on
more » ... cise-induced myocardial ischemia in men. Methods and Results-After withdrawal of antianginal therapy, 14 men (mean age, 58Ϯ4 years) with coronary artery disease underwent 3 exercise tests according to the modified Bruce protocol on 3 different days (baseline and either testosterone or placebo given in a random order). The exercise tests were performed 30 minutes after administration of testosterone (2.5 mg IV in 5 minutes) or placebo. All patients showed at least 1-mm ST-segment depression during the baseline exercise test and after placebo, whereas only 10 patients had a positive exercise test after testosterone. Chest pain during exercise was reported by 12 patients during baseline and placebo exercise tests and by 8 patients after testosterone. Compared with placebo, testosterone increased time to 1-mm ST-segment depression (579Ϯ204 versus 471Ϯ210 seconds; PϽ0.01) and total exercise time (631Ϯ180 versus 541Ϯ204 seconds; PϽ0.01). Testosterone significantly increased heart rate at the onset of 1-mm ST-segment depression (135Ϯ12 versus 123Ϯ14 bpm; PϽ0.01) and at peak exercise (140Ϯ12 versus 132Ϯ12 bpm; PϽ0.01) and the rate-pressure product at the onset of 1-mm ST-segment depression (24 213Ϯ3750 versus 21 619Ϯ3542 mm Hgϫbpm; PϽ0.05) and at peak exercise (26 746Ϯ3109 versus 22 527Ϯ5443 mm Hgϫbpm; PϽ0.05). Conclusions-Short-term administration of testosterone induces a beneficial effect on exercise-induced myocardial ischemia in men with coronary artery disease. This effect may be related to a direct coronary-relaxing effect. (Circulation. 1999;99:1666-1670.)
doi:10.1161/01.cir.99.13.1666 pmid:10190874 fatcat:53imursagzguzbzrkqu7c2k2ua