Impact of Serum Testosterone Titres on Complexity of Coronary Lesions in Premature Ischemic Egyptian Males: Angiographic Based Study

Background: Premature ischemic heart disease (IHD) is a significant health concern, particularly in young males, who are often not considered at high risk for coronary artery disease (CAD).
Objective: This work investigated the association between serum testosterone titres and the angiographic complexity of coronary lesions in males <45 years presenting with premature IHD.
Patients and Methods: This prospective study involved 50 male patients, <45 years, diagnosed with premature IHD, and undergoing elective coronary angiography. Patients were divided based on the complexity of coronary lesions (by SYNTAX score) into two equal groups: the significant CAD and the Non-complex CAD groups. Before coronary angiography, hormonal assays for testosterone titres and routine laboratory investigations were done.
Results: Total testosterone and SHBG were comparable between the groups. The significant CAD group had substantially diminished free testosterone as opposed to the non-complex CAD group [0.09 (0.04-0.21) vs 0.19 (0.09-0.35) ng/dl, P=0.01]. Luteinizing (LH) and follicle-stimulating (FSH) hormones, and estradiol were substantially elevated in the significant CAD group (P<0.001). Multivariate regression confirmed that serum albumin, total testosterone, free testosterone, FSH, and estradiol were independent predictors of coronary lesion complexity (P<0.05).
Conclusions: In premature ischemic Egyptian males, diminished serum testosterone titres were substantially associated with increased complexity of coronary artery lesions. Free testosterone emerged as an independent predictor of lesion complexity.