Correlation of the severity of obstruction in coronary arteries with serum free testosterone level

Background: Coronary artery disease (CAD) is the leading cause of death in India. There was increased incidence and prevalence of CAD in males than in females. There have been several studies going on across the globe to find a similar equation in males between testosterone and CAD. This study aimed at correlating the serum free testosterone level in CAD patients with the severity of obstruction of the coronary arteries proven by coronary angiogram. This was the first study in South India to correlate the serum free testosterone levels with the severity of obstruction of coronaries. Objective: This study was designed to correlate the serum free testosterone level in male patients above 40 years with proven or newly diagnosed CAD with the severity of obstruction of coronary arteries as evidenced from coronary angiogram. Materials and Methods: This was a hospital-based cross-sectional study conducted from November 2015 to August 2017 in a rural-based teaching tertiary care hospital in Puducherry, India. The sample size was 40, calculated using the formula n = 4 × σ2/d2 from the previous study of serum free testosterone in men with coronary artery atherosclerosis done by Lucyna Siemińska et al. Results: Of 40 patients in the study group, 30% had CAD, 20% had hypertension (HTN), 45% had diabetes mellitus, 45% were smokers, 37.5% were alcoholic, and only 5% had family history of (H/o) CAD. In the study, ejection fraction was < 60 in 80% and ≥ 60 in 20%. In the study, 42.5% had single-vessel disease, 27.5% had double-vessel disease, and 30% had triple-vessel disease. The mean serum testosterone was 4.5 ± 3.1 and the median serum testosterone was 3.3, which showed that most of the patients with CAD had their testosterone levels in the lower range of normal. Conclusion: From the observations made in this study, it was clear that the skewing of serum free testosterone levels toward the lower side of normal can be taken as an indirect evidence that serum free testosterone is inversely related to CAD. There was no significant difference in median testosterone levels with respect to the type of disease. However, a statistically significant positive association between H/o systemic HTN and serum free testosterone level was observed in patients with CAD.