Effects of Exogenous Testosterone Replacement Therapy on Time to ST Segment Depression and Myocardial Ischemia in Men With Chronic Stable Angina

Background: Testosterone levels in men decline with age and low testosterone levels or hypogonadism can cause multiple negative effects and symptoms. Studies have shown that exogenous testosterone replacement therapy at physiological levels has a number of beneficial and protective effects on mood, libido, strength, lean body mass, bone health and cardiovascular health. One of the many cardiovascular benefits of testosterone therapy is its action as a vasodilator and effect on angina and exercise induced myocardial ischemia. This purpose of this paper is to review the effects of exogenous testosterone therapy in eugonadal and hypogonadal men with chronic stable angina. All evidence will be evaluated using the GRADE method. Method: An exhaustive search of available medical literature was conducted through Medline, EBM, and CINHAL databases. Results: Two randomized controlled trials were reviewed along with the outcome of time to 1mm ST segment depression on treadmill exercise testing. Both studies showed statistically relevant improvements in time to 1mm ST segment depression as well as improvements in total exercise time. Impact on overall quality of life also showed significant improvement verses placebo. Both studies showed an insiginificant increase in Hematocrit and PSA levels but all within normal physiologic ranges. No other adverse effects were seen. Conclusion: Exogenous testosterone replacement therapy improves overall exercise time and time to 1mm ST segment depression in male eugonadal and hypogonadal patients with angina and myocardial ischemia. Overall GRADE of evidence was considered to be moderate. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/250 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/250 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. Effects of Exogenous Testosterone Replacement Therapy on Time to ST Segment Depression and Myocardia A course paper presented to the College of Health Professions in partial fulfillment of the requirements of the degree of Pacific University School of Physician Assistant Studies Faculty Advisor: Clinical Graduate Project Instructors: Torry Cobb, DHSc l Ischemia in Men With Chronic Stable Angina