Cardiac surgery
The association between serum testosterone levels and coronary artery disease in middle-aged men

Background: The relation between coronary artery disease (CAD) and the levels of serum androgen has been revealed in various population studies. The Gensini coronary scoring system is used to evaluate the degree of coronary stenosis, taking into account its location and producing a numerical score.

The aim of the study was to explore the association between serum testosterone levels and both the presence and severity of coronary artery disease indicated by the Gensini score in middle-aged men.

Material and methods: Between October 2011 and April 2012, 124 middle-aged (40-59) male patients with known or suspected coronary artery disease were included in the study. Coronary angiography was performed in all patients, and their Gensini scores were calculated. Total serum testosterone levels were also measured.

Results: The mean Gensini score of the patients was 44.11 ±39.08. The mean plasma testosterone level was 3.51 ±1.39 ng/ml. There was no correlation between the severity of coronary artery disease and the serum testosterone levels (r = –0.161, p > 0.05). When the patients with coronary artery disease (Gensini score ≥ 1) were compared with the patients without it (n = 29, Gensini score: 0), their mean serum testosterone levels were revealed to be lower (p = 0.043). There was no correlation between the testosterone levels and the high-density lipoprotein cholesterol and triglyceride levels. There was a correlation between the serum testosterone levels and total cholesterol levels (p = 0.008), low-density lipoprotein cholesterol levels (p = 0.019), and body mass index (p = 0.001).

Conclusions: The mean serum testosterone levels were lower in the CAD group. We did not manage to document their relation with disease severity by means of the Gensini score.