Low-dose transdermal testosterone therapy improves angina threshold in menwith chronic stable angina - A randomized, double-blind, placebo-controlled study

Background-Experimental studies suggest that androgens induce coronary vaso dilatation. We performed this pilot project to examine the clinical effects of long-term low-dose androgens in men with angina. Methods and Results-Forty-six men with stable angina completed a 2-week, si ngle-blind placebo run-in, followed by double-blind randomization to 5 mg t estosterone daily by transdermal patch or matching placebo for 12 weeks, in addition to their current medication. Time to l-mm ST-segment depression o n treadmill exercise testing and hormone levels were measured and quality o f life was assessed by SF-36 at baseline and after 4 and 12 weeks of treatm ent. Active treatment resulted in a 2-fold increase in androgen levels and an increase in time to l-mm ST-segment depression from (mean+/-SEM) 309+/-2 7 seconds at baseline to 343+/-26 seconds after 4 weeks and to 361+/-22 sec onds after 12 weeks. This change was statistically significant compared wit h that seen in the placebo group (from 266+/-25 seconds at baseline to 284/-23 seconds after 4 weeks and to 292+/-24 seconds after 12 weeks; P=0.02 b etween the 2 groups by ANCOVA). The magnitude of the response was greater i n those with lower baseline levels of bioavailable testosterone (r=-0.455, P<0.05). There were no significant changes in prostate specific antigen, he moglobin, lipids, or coagulation profiles during the study. There were sign ificant improvements in pain perception (P=0.026) and role limitation resul ting from physical problems (P=0.024) in the testosterone-treated group. Conclusions-Low-dose supplemental testosterone treatment in men with chroni c stable angina reduces exercise-induced myocardial ischemia.