Low Testosterone is Associated with an Increased Risk of MACE Lethality in Subjects with Erectile Dysfunction

ABSTRACT Introduction Although testosterone (T) has been suggested to play a protective role against the development of atherosclerosis, studies demonstrating an association between low T and incident major adverse cardiovascular events (MACE) are scanty in the general population and absent in subjects with erectile dysfunction (ED). Aim To investigate whether low T in subjects with ED predict incident fatal or nonfatal MACE. Methods This is an observational prospective cohort study evaluating a consecutive series of 1687 patients attending our andrological unit for ED. Patients were interviewed using the structured interview on erectile dysfunction (SIEDY) and ANDROTEST structured interviews measuring components relative to ED and hypogonadal-related symptoms, respectively. Main Outcome Measures Total T was evaluated at baseline. Information on MACE was obtained through the City of Florence Registry Office. Results Among the patients studied, 5.2, 13.8, and 22.4% were hypogonadal according to different thresholds (T  P P  = 0.05 after adjustment for age and Chronic Diseases Score). Conclusions T levels are associated with a higher mortality of MACE. The identification of low T levels should alert the clinician thus identifying subjects with an increased cardiovascular risk. Corona G, Monami M, Boddi V, Cameron-Smith M, Fisher A, de Vita G, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, and Maggi M. Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction.