PMID- 33781026
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20220721
IS  - 2724-6442 (Electronic)
IS  - 2724-6051 (Linking)
VI  - 74
IP  - 4
DP  - 2022 Aug
TI  - Testosterone replacement therapy in hypogonadal male patients with hypogonadism 
      and heart failure: a meta-analysis of randomized controlled studies.
PG  - 418-427
LID - 10.23736/S2724-6051.21.04307-X [doi]
AB  - INTRODUCTION: The recently published guidelines of the European Academy of 
      Andrology (EAA) recommended not to prescribe testosterone replacement therapy 
      (TRT) in male patients with hypotestosteronemia and severe heart failure (HF) 
      [New York Hearth Association (NYHA) class III and IV] since the risk in these 
      patients has not been formally documented. Therefore, the aim of this study was 
      to systematically evaluate the risk of TRT on the cardiac function and angina, in 
      male patients with hypotestosteronemia and HF or coronary heart disease. EVIDENCE 
      ACQUISITION: Randomized controlled trials (RCTs) on male patients with 
      hypotestosteronemia and chronic HF (ejection fraction <40%) or stable angina 
      documenting the effect of TRT on NYHA class, left ventricular ejection fraction 
      (LVEF), adverse events, ST depression and other indexes of cardiovascular 
      function. EVIDENCE SYNTHESIS: Seven articles were included, for a total of 140 
      participants with HF (71 on TRT and 69 on placebo or no treatment). Included 
      patients were of NYHA class II and III. TRT had no effect on death and 
      rehospitalization rates of patients with HF and significantly delayed the time to 
      ischemia in patients with chronic angina. TRT had no effect on the NYHA class, 
      the LVEF, and on the Minnesota Living with Heart Failure questionnaire. Although 
      a significant increase of oxygen consumption was found in the TRT group, no 
      improvement to the physical exercise tolerance tests was observed. TRT showed no 
      effect on systolic nor diastolic blood pressure, but it significantly ameliorated 
      the heart rate. It significantly decreased the insulin serum levels and the HOMA 
      index. CONCLUSIONS: These results suggest the safety of TRT, in patients with 
      hypotestosteronemia and severe HF (class NYHA II and III). Although deriving from 
      a limited number of studies, these data could prompt to perform other RCTs on the 
      effects of TRT in patients with hypotestosteronemia and severe HFrEF (NYHA class 
      III).
FAU - Cannarella, Rossella
AU  - Cannarella R
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - Barbagallo, Federica
AU  - Barbagallo F
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - Crafa, Andrea
AU  - Crafa A
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - Mongioi, Laura M
AU  - Mongioi LM
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - Aversa, Antonio
AU  - Aversa A
AD  - Department of Experimental and Clinical Medicine, Magna Graecia University, 
      Catanzaro, Italy.
FAU - Greco, Emanuela
AU  - Greco E
AD  - Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
FAU - Condorelli, Rosita A
AU  - Condorelli RA
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - LA Vignera, Sandro
AU  - LA Vignera S
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy - sandrolavignera@unict.it.
FAU - Calogero, Aldo E
AU  - Calogero AE
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210329
PL  - Italy
TA  - Minerva Urol Nephrol
JT  - Minerva urology and nephrology
JID - 101777299
RN  - 3XMK78S47O (Testosterone)
SB  - IM
MH  - *Heart Failure/complications/drug therapy
MH  - Humans
MH  - *Hypogonadism/chemically induced/drug therapy
MH  - Male
MH  - *Randomized Controlled Trials as Topic
MH  - Stroke Volume/physiology
MH  - Testosterone/therapeutic use
MH  - Ventricular Function, Left
EDAT- 2021/03/31 06:00
MHDA- 2022/07/20 06:00
CRDT- 2021/03/30 02:53
PHST- 2021/03/31 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2021/03/30 02:53 [entrez]
AID - S2724-6051.21.04307-X [pii]
AID - 10.23736/S2724-6051.21.04307-X [doi]
PST - ppublish
SO  - Minerva Urol Nephrol. 2022 Aug;74(4):418-427. doi: 
      10.23736/S2724-6051.21.04307-X. Epub 2021 Mar 29.