PDF(Pubmed)
Abstract：
UNASSIGNED: A cardiovascular safety trial of testosterone in men with cardiovascular risk factors or disease found no difference in rates of major adverse cardiovascular events (MACE) or death but noted more atrial fibrillation (AF) events in testosterone-treated men. We investigated the relationship between endogenous testosterone concentrations with risk of developing AF in healthy older men.
UNASSIGNED: Post-hoc analysis of 4570 male participants in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Men were aged ≥ 70 years, had no history of cardiovascular disease (including AF), thyroid disease, prostate cancer, dementia, or life-threatening illnesses. Risk of AF was modelled using Cox proportional hazards regression.
UNASSIGNED: Median (IQR) age was 73.7 (71.6-77.1) years and median (IQR) follow-up 4.4 (3.3-5.5) years, during which 286 men developed AF (15.3 per 1000 participant-years). Baseline testosterone was higher in men who developed incident AF compared men who did not [17.0 (12.4-21.2) vs 15.7 (12.2-20.0) nmol/L]. There was a non-linear association of baseline testosterone with incident AF. The risk for AF was higher in men with testosterone in quintiles (Q) 4&5 (Q4:Q3, HR = 1.91; 95%CI = 1.29-2.83 and Q5:Q3HR = 1.98; 95%CI = 1.33-2.94). Results were similar after excluding men who experienced MACE or heart failure during follow-up.
UNASSIGNED: Circulating testosterone concentrations within the high-normal range are independently associated with an increased risk of incident AF amongst healthy older men. This suggests that AF may be an adverse consequence of high-normal total testosterone concentrations.
UNASSIGNED: National Institute on Aging and National Cancer Institute at the National Institutes of Health; Australian Government (NHMRC, CSIRO); Monash University; and AlfredHealth.
UNASSIGNED: Post-hoc analysis of 4570 male participants in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Men were aged ≥ 70 years, had no history of cardiovascular disease (including AF), thyroid disease, prostate cancer, dementia, or life-threatening illnesses. Risk of AF was modelled using Cox proportional hazards regression.
UNASSIGNED: Median (IQR) age was 73.7 (71.6-77.1) years and median (IQR) follow-up 4.4 (3.3-5.5) years, during which 286 men developed AF (15.3 per 1000 participant-years). Baseline testosterone was higher in men who developed incident AF compared men who did not [17.0 (12.4-21.2) vs 15.7 (12.2-20.0) nmol/L]. There was a non-linear association of baseline testosterone with incident AF. The risk for AF was higher in men with testosterone in quintiles (Q) 4&5 (Q4:Q3, HR = 1.91; 95%CI = 1.29-2.83 and Q5:Q3HR = 1.98; 95%CI = 1.33-2.94). Results were similar after excluding men who experienced MACE or heart failure during follow-up.
UNASSIGNED: Circulating testosterone concentrations within the high-normal range are independently associated with an increased risk of incident AF amongst healthy older men. This suggests that AF may be an adverse consequence of high-normal total testosterone concentrations.
UNASSIGNED: National Institute on Aging and National Cancer Institute at the National Institutes of Health; Australian Government (NHMRC, CSIRO); Monash University; and AlfredHealth.
摘要：
■一项在患有心血管危险因素或疾病的男性中使用睾酮的心血管安全性试验发现，主要不良心血管事件（MACE）或死亡的发生率没有差异，但在接受睾酮治疗的男性中发现了更多的房颤（AF）事件。我们调查了内源性睾酮浓度与健康老年男性发生房颤风险之间的关系。
■ASPirin减少老年人事件（ASPREE）研究中4570名男性参与者的事后分析。男性年龄≥70岁，无心血管疾病史（包括房颤），甲状腺疾病,前列腺癌,痴呆症,或是危及生命的疾病.使用Cox比例风险回归模拟房颤风险。
■中位（IQR）年龄为73.7（71.6-77.1）岁，中位（IQR）随访4.4（3.3-5.5）年，286名男性发生房颤(15.3/1000参与者-年).与未发生房颤的男性相比，发生房颤的男性的基线睾丸激素较高[17.0（12.4-21.2）vs15.7（12.2-20.0）nmol/L]。基线睾酮与房颤事件之间存在非线性关联。男性睾酮在五分位数（Q）4和5（Q4：Q3，HR=1.91;95CI=1.29-2.83和Q5：Q3HR=1.98;95CI=1.33-2.94）中房颤风险较高。排除在随访期间经历MACE或心力衰竭的男性后，结果相似。
正常范围内的循环睾酮浓度与健康老年男性发生房颤的风险增加独立相关。这表明AF可能是正常总睾酮浓度高的不良后果。
■国家卫生研究院的国家衰老研究所和国家癌症研究所；澳大利亚政府（NHMRC，CSIRO）；莫纳什大学；和AlfredHealth。
■ASPirin减少老年人事件（ASPREE）研究中4570名男性参与者的事后分析。男性年龄≥70岁，无心血管疾病史（包括房颤），甲状腺疾病,前列腺癌,痴呆症,或是危及生命的疾病.使用Cox比例风险回归模拟房颤风险。
■中位（IQR）年龄为73.7（71.6-77.1）岁，中位（IQR）随访4.4（3.3-5.5）年，286名男性发生房颤(15.3/1000参与者-年).与未发生房颤的男性相比，发生房颤的男性的基线睾丸激素较高[17.0（12.4-21.2）vs15.7（12.2-20.0）nmol/L]。基线睾酮与房颤事件之间存在非线性关联。男性睾酮在五分位数（Q）4和5（Q4：Q3，HR=1.91;95CI=1.29-2.83和Q5：Q3HR=1.98;95CI=1.33-2.94）中房颤风险较高。排除在随访期间经历MACE或心力衰竭的男性后，结果相似。
正常范围内的循环睾酮浓度与健康老年男性发生房颤的风险增加独立相关。这表明AF可能是正常总睾酮浓度高的不良后果。
■国家卫生研究院的国家衰老研究所和国家癌症研究所；澳大利亚政府（NHMRC，CSIRO）；莫纳什大学；和AlfredHealth。
