FEATURES OF DIAGNOSIS OF AGE-OLD HYPOGONADISM IN MEN WITH CORONARY ARTERY DISEASE

Khaniukov O. O., Bucharskyi O. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

At present, the issue of providing care to patients with cardiovascular disease (CVD), in particular coronary heart disease (CHD), which, despite advances in modern medicine, remains the leading cause of death in Ukraine and around the world. According to the Global Burden of Disease study for 2019, cardiovascular disease is the most common cause of death in Ukraine, accounting for 64.3% of total deaths in 2019. Well-known conditions that affect the cardiovascular prognosis include smoking, hypertension, lipid metabolism disorders, genetic predisposition, male gender, age, diabetes, insufficient physical activity, but at the same time the search for new factors that modify it continues. These include hypogonadism in men, which affects the course of cardiovascular disease (CVD), coronary heart disease (CHD) and cardiovascular prognosis in men, shown in studies. In view of this, the question arises of developing algorithms for the diagnosis of androgen deficiency in men with coronary heart disease. This prospective study included 37 men with chronic coronary heart disease (stable angina pectoris, postinfarction and atherosclerotic cardiosclerosis), aged 45 to 65 years, who were hospitalized. In addition to routine clinical and paraclinical examinations, patients were tested for total and bound plasma testosterone, prostate specific antigen (PSA); There was also a survey on the AMS questionnaire (The Aging Males’ Symptoms Scale), a questionnaire for men on the presence of age symptoms, where the patient is asked to answer a series of questions, assessing the severity of age symptoms from 1 (no symptoms) to 5 (very severe) after which the sum of points is calculated). As a result of the study, it was found that its sensitivity to detect androgen deficiency was 100%, while the specificity – 67.7%, respectively. Spearman’s rank correlation coefficient between total testosterone levels and the score obtained from the AMS questionnaire was -0.63 (p<0.01), which corresponds to a moderate negative correlation. Thus, it can be concluded that testing on the AMS questionnaire can be used to screen for the presence of hypogonadism in men with coronary heart disease.

androgen deficiency, hypogonadism, coronary artery disease.

1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990- 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. DOI: 10.1016/S0140- 6736(20)30925-9.
2. Elagizi A, Köhler TS, Lavie CJ. Testosterone and Cardiovascular Health. Mayo Clin Proc. 2018 Jan;93(1):83-100. DOI: 10.1016/j. mayocp.2017.11. 006.
3. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373-498. DOI: 10.1093/eurheartj/ehaa612.
4. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation. 2019;140(2):e125-e151. DOI: 10.1161/CIR.0000000000000665.
5. Zeller T, Schnabel RB, Appelbaum S, Ojeda F, Berisha F, Schulte-Steinberg B, et al. Low testosterone levels are predictive for incident atrial fibrillation and ischaemic stroke in men, but protective in women – results from the FINRISK study. Eur J Prev Cardiol. 2018;25(11):1133- 1139. DOI: 10.1177/2047487318778346.
6. Lai J, Zhou D, Xia S, Shang Y, Want L, Zheng L, et al. Reduced testosterone levels in males with lone atrial fibrillation. Clin Cardiol. 2009;32(1):43-46. DOI: 10.1002/clc.20423
7. Kirby M, Hackett G, Ramachandran S. Testosterone and the Heart. Eur Cardiol. 2019 Jul 11;14(2):103-110. DOI: 10.15420/ecr.2019.13.1.
8. Webb CM, McNeill JG, Hayward CS, de Zeigler D, Collins P. Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease. Circulation. 1999;100(16):1690-1696. DOI: 10.1161/01.cir.100.16. 1690.
9. Malkin CJ, Pugh PJ, Morris PD, Kerry KE, Jones RD, Jones TH, et al. Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life. Heart. 2004 Aug;90(8):871-6. DOI: 10.1136/hrt.2003.021121.
10. Chahla EJ, Hayek ME, Morley JE. Testosterone replacement therapy and cardiovascular risk factors modification. Aging Male. 2011;14(2):83-90. DOI: 10.3109/13685538.2010.541538.
11. Sharma R, Oni OA, Gupta K, Sharma M, Sharma R, Singh V, et al. Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation. J Am Heart Assoc. 2017;6(5):e004880. DOI: 10.1161/ JAHA.116.004880.

«Bulletin of problems biology and medicine» Issue 1 (163), 2022 year, 172-176 pages, index UDK 616.693-053-07:612.67:616.12-005.4

10.29254/2077-4214-2022-1-163-172-176