RELATIONSHIP BETWEEN SERUM TESTOSTERONE LEVELS AND SHORT TERM MORTALITY IN MEN WITH ACUTE MYOCARDIAL INFARCTION

Author(s): Sumit Kumar, BS Bal, Ravinder Garg, Manjit Rai, Suraj Kumar and Kirti

Abstract

Large prospective studies have not been able to confirm the significant and independent association between endogenous testosterone levels and coronary events in men or women. Still a few small studies have shown inverse correlation between endogenous testosterone level with general and cardiovascular mortality.100 men with first attack of acute myocardial infarction (AMI) were assessed for relationship between serum testosterone levels within first 24 hours and short term (30 days) mortality. The mean age was 59.13±9.6. Out of 100 cases, STEMI was present in 70%, diabetes in 44%, hypertension in 48% and 33% were smokers. At the time of admission, serum free testosterone, hs-CRP, lipid profile and left ventricular ejection fraction were assessed. All cases were analyzed for 30 days mortality. The mean level of serum testosterone was 4.185±1.46ng/ml. There were 77% survivors and 33% non survivors at the end of 30 days follow up. All the non survivors had testosterone levels <3.5ng/dl with mean of 2.801±0.498 versus 4.598±1.392 in survivors (p<0.001). The fall in testosterone level was associated with rise in hs-CRP; total cholesterol; LDL and triglycerides but with fall in HDL (p<0.004) and LV ejection fraction (p<0.026). It signifies direct correlation of rising hs-CRP and falling EF with increase in mortality. A low level of free testosterone in AMI was directly correlated to total short term (<30 days) mortality. It can serve as a marker for assessing the prognosis in fresh myocardial infarction.

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