Mp76-05 Revisiting Risk of Testosterone Therapy: Assessing the Impact of Supratherapeutic Levels on Mace and Mortality

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-05 REVISITING RISK OF TESTOSTERONE THERAPY: ASSESSING THE IMPACT OF SUPRATHERAPEUTIC LEVELS ON MACE AND MORTALITY Sirpi Nackeeran, Christabel Egemba, Aaron Gurayah, and Ranjith Ramasamy Sirpi NackeeranSirpi Nackeeran , Christabel EgembaChristabel Egemba , Aaron GurayahAaron Gurayah , and Ranjith RamasamyRanjith Ramasamy View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The recent TRAVERSE trial provided evidence for the cardiac safety of testosterone therapy. However, the patients studied had median post-treatment testosterone levels less than 400 ng/dL. In light of these findings, we sought to investigate whether supra-therapeutic T levels ( >1000 ng/dL) are associated with an elevated risk of MACE and/or mortality. METHODS: We collected data from the NHANES 2011-2016 and linked them to the National Death Index (NDI) through 2019. The NHANES is a national survey run by the Center for Disease Control that assesses the health status of United States residents by sampling of populations across the country. NDI is a centralized database of United States death record information on file in state vital statistics offices. We included adult males with total testosterone data who were eligible for mortality data. We compared participants with testosterone >1000 ng/dL against those with <1000 ng/dL, assuming that those >1000 ng/dL were taking testosterone. Our primary outcome was mortality, with secondary outcomes of mortality due to MACE. We used binary logistic regression and controlled for age, race, body mass index, and history of myocardial infarction. Statistical significance was assessed at p<0.05. RESULTS: We identified 7,790 males aged 18 or older with mortality data. Of those, 7,715 had testosterone <1000 and 75 men had testosterone >1000. Among all patients in our cohort, 643 died of all causes, and 199 died of MACE. In the multivariable logistic regression, we found testosterone >1000 was associated with all-cause mortality (OR 2.59, 95% CI 1.29-5.20, p=0.007). There was no association with mortality from MACE in either all participants (OR 0.60, 95% CI 0.08-4.45, p=0.615) or among those who died (OR 0.28, 95% CI 0.03-2.17, p=0.221). CONCLUSIONS: Supratherapeutic levels of testosterone are associated with all-cause mortality by 2019 in NHANES participants from 2011-2016. There were no associations with MACE in this population, although overall numbers of death from MACE were low in this data set. Future studies should examine longitudinal data across a greater duration and consider non-fatal MACE events in men who achieve supra-therapeutic levels on TT. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1244 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sirpi Nackeeran More articles by this author Christabel Egemba More articles by this author Aaron Gurayah More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement PDF downloadLoading ...