Coronary Artery Disease Clinical Trial
Official title:
Study to Evaluate the Association of Testosterone Levels With Coronary Artery in Patients With Stable Coronary Artery Disease
Coronary artery calcification (CAC) is a pandemic condition in elderly patients with coronary artery disease (CAD) and associated with worse prognosis. Although available data shows association between testosterone levels in men and CAD, the association between testosterone and CAC in old-aged male patients with CAD remains unknown. In this study, the relationship of serum testosterone levels with CAC score in elderly male patients with CAD was evaluated.
Coronary artery calcification (CAC) is associated with worse outcomes in patients with
coronary artery disease (CAD), especially in old-aged population. Extensive CAC also
increases the risk of procedure associated complications, such as stent migration, coronary
artery perforation, dissection and thrombosis. The pathogenesis of CAC has not been fully
explained. Recent evidence suggests that CAC share common pathways with bone formation. So,
it can be presumed that risk factors contributing to bone formation and resorption activity
also affect the development of CAC. Sex hormones is known to play an important role in bone
development and in bone quality maintenance. Available data shows that androgens may affect
differentiation, proliferation, and apoptosis of osteocytes, osteoclasts, and osteoblasts.
Androgen receptor expression has been detected on different types of cells which
contributing to the bone formation, such as osteoblastes, osteocytes and condrocytes, and
androgen deprivation therapy results negative effects on bone mineral density in patients
with metastatic prostate cancer. Osteoporosis, a systemic disease characterized by bone
tissue loss, is more prevalent in oler men with low testosterone levels. In CAC,
pathophysiological researches show that several vascular cell types, such as vascular smooth
muscle cells, adventitial myofibroblasts and microvascular pericytes, have the potential to
produce mineralized matrix and differentiate into osteoblasts. So, it can be postulated that
androgens may play a similar role in the development of CAC.
Up to date, only limited data is available about the association between testosterone and
CAC. A single-center study with relatively small sample revealed an inverse association
between testosterone and CAC in non-obese men. The aim of this study was to investigate the
association between testosterone and CAC measured as CAC score in old-aged male patients
with CAD.
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