Fabrice Bonnet, Patricia Vaduva, Beverley Balkau, Thibaud Genet, Jean Baptiste de Freminville, Pierre-Henri Ducluzeau, Laurent Fauchier
{"title":"Testosterone therapy and the risk of atrial fibrillation, venous thromboembolism and cardiovascular events in cis men with hypogonadism and trans men.","authors":"Fabrice Bonnet, Patricia Vaduva, Beverley Balkau, Thibaud Genet, Jean Baptiste de Freminville, Pierre-Henri Ducluzeau, Laurent Fauchier","doi":"10.1093/ejendo/lvaf183","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>While the cardiovascular safety of testosterone therapy in men remains controversial, limited data exist for trans men treated with testosterone. We assessed cardiovascular events, mortality, and suicide attempts under testosterone therapy in both cis men with hypogonadism and trans men.</p><p><strong>Methods: </strong>Participants were recruited from the TriNetX Research network. We compared 117 908 cis men with hypogonadism treated with testosterone with 1:1 propensity score matched cis men not treated. We compared 6251 trans men treated with 6251 trans men not treated with testosterone and 6986 trans men treated to 6986 cis men not treated with testosterone.</p><p><strong>Results: </strong>After 5 years of follow-up, cis men with testosterone therapy had a lower risk of myocardial infarction (HR [hazard ratio]: 0.94, 95% confidence interval [CI] [0.89-0.99], P = .01) with no difference for stroke or mortality, but higher risks of atrial fibrillation (1.27 [1.22-1.32], P < .0001) and acute pulmonary embolism/deep vein thrombosis (1.26 [1.18-1.34], P < .0001). Trans men treated with testosterone had no significant increase in the rate of cardiovascular outcomes as compared to both untreated trans and cis men. There was a lower rate of suicide attempts for trans men treated with testosterone as compared to untreated trans men (0.52 [0.35-0.78], P = .001), without significant differences when compared to untreated cis men.</p><p><strong>Conclusions: </strong>Testosterone treatment in cis men with hypogonadism was associated with a lower risk of myocardial infarction but a higher risk of atrial fibrillation and venous thromboembolism. Testosterone therapy in trans men was not associated with an increased risk of cardiovascular events when compared to untreated trans men or cis men.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"374-382"},"PeriodicalIF":5.2000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ejendo/lvaf183","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: While the cardiovascular safety of testosterone therapy in men remains controversial, limited data exist for trans men treated with testosterone. We assessed cardiovascular events, mortality, and suicide attempts under testosterone therapy in both cis men with hypogonadism and trans men.
Methods: Participants were recruited from the TriNetX Research network. We compared 117 908 cis men with hypogonadism treated with testosterone with 1:1 propensity score matched cis men not treated. We compared 6251 trans men treated with 6251 trans men not treated with testosterone and 6986 trans men treated to 6986 cis men not treated with testosterone.
Results: After 5 years of follow-up, cis men with testosterone therapy had a lower risk of myocardial infarction (HR [hazard ratio]: 0.94, 95% confidence interval [CI] [0.89-0.99], P = .01) with no difference for stroke or mortality, but higher risks of atrial fibrillation (1.27 [1.22-1.32], P < .0001) and acute pulmonary embolism/deep vein thrombosis (1.26 [1.18-1.34], P < .0001). Trans men treated with testosterone had no significant increase in the rate of cardiovascular outcomes as compared to both untreated trans and cis men. There was a lower rate of suicide attempts for trans men treated with testosterone as compared to untreated trans men (0.52 [0.35-0.78], P = .001), without significant differences when compared to untreated cis men.
Conclusions: Testosterone treatment in cis men with hypogonadism was associated with a lower risk of myocardial infarction but a higher risk of atrial fibrillation and venous thromboembolism. Testosterone therapy in trans men was not associated with an increased risk of cardiovascular events when compared to untreated trans men or cis men.
期刊介绍：
European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica.
The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology.
Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials.
Equal consideration is given to all manuscripts in English from any country.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
