Testosterone replacement therapy and vascular thromboembolic events: a systematic review and meta-analysis  

作　　者：Rossella Cannarella Carmelo Gusmano Claudia Leanza Vincenzo Garofalo Andrea Crafa Federica Barbagallo Rosita A Condorelli Sandro La Vignera Aldo E Calogero 

机构地区：[1]Department of Clinical and Experimental Medicine,University of Catania,Catania 95123,Italy [2]Glickman Urological&Kidney Institute,Cleveland Clinic Foundation,Cleveland,OH44195,USA

出　　处：《Asian Journal of Andrology》2024年第2期144-154,共11页亚洲男性学杂志（英文版）

摘　　要：To evaluate the relationship between testosterone replacement therapy(TRT)and arterial and/or venous thrombosis in patients with pre-treatment total testosterone(TT)<12 nmol I^(-1),we performed a meta-analysis following the Population Intervention Comparison Outcome model.Population:men with TT<12 nmol I^(-1) or clear mention of hypogonadism in the inclusion criteria of patients;intervention:TRT;comparison:placebo or no therapy;outcomes:arterial thrombotic events(stroke,myocardial infarction[MI],upper limbs,and lower limbs),VTE(deep vein thrombosis[DVT],portal vein thrombosis,splenic thrombosis,and pulmonary embolism),and mortality.A total of 2423 abstracts were assessed for eligibility.Twenty-four studies,including 14 randomized controlled trials(RCTs),were finally included,with a total of 4027 and 310288 hypotestosteronemic male patients,from RCTs and from observational studies,respectively.Based on RCT-derived data,TRT did not influence the risk of arterial thrombosis(odds ratio[OR]=1.27,95%confidence interval[CI]:0.47-3.43,P=0.64),stroke(OR=1.34,95%CI:0.09-18.97,P=0.83),MI(OR=0.51,95%CI:0.11-2.31,P=0.39),VTE(OR=1.42,95%CI:0.22-9.03,P=0.71),pulmonary embolism(OR=1.38,95%CI:0.27-7.04,P=0.70),and mortality(OR=0.70,95%CI:0.20-2.38,P=0.56).Meanwhile,when only observational studies are considered,a significant reduction in the risk of developing arterial thrombotic events,Ml,venous thromboembolism,and mortality was observed.The risk for DVT remains uncertain,due to the paucity of RCT-based data.TRT in men with TT<12 nmol I^(-1) is safe from the risk of adverse cardiovascular events.Further studies specifically assessing the risk of DVT in men on TRT are needed.

关 键 词：HYPOGONADISM TESTOSTERONE testosterone replacement therapy THROMBOEMBOLISM THROMBOSIS TRT 

分 类 号：R697[医药卫生—泌尿科学]