# Association Between Serum Testosterone Levels and Coronary Artery Stenosis: A Cross-Sectional Study in Central European Population

## TL;DR

This study finds that higher testosterone levels are linked to more severe coronary artery blockages in a Slovak population, contradicting some previous findings.

## Contribution

The study provides new evidence from a Central European population showing elevated testosterone is associated with increased coronary stenosis.

## Key findings

- Patients with coronary stenosis had significantly higher testosterone levels than those without.
- Testosterone remained independently associated with stenosis after adjusting for age, sex, diabetes, and LDL cholesterol.
- The findings suggest testosterone's role in CAD may differ between chronic and acute cases.

## Abstract

Background: The relationship between testosterone and coronary artery disease (CAD) remains a subject of debate. Most studies suggest an inverse association—lower testosterone, higher risk. However, data from Central European populations undergoing coronary angiography are limited. Objectives: To investigate the association between serum testosterone levels and angiographically confirmed coronary artery stenosis in a Slovak population. Methods: This cross-sectional study included 129 consecutive stable patients (84 men, 45 women; mean age 64.3 ± 9.7 years) undergoing elective coronary angiography for suspected stable coronary artery disease. Significant coronary stenosis was defined as ≥50% luminal narrowing in any major epicardial vessel. Serum testosterone, lipid profile, and traditional risk factors were assessed. Univariate and multivariate logistic regression models were constructed to evaluate independent associations of coronary stenosis. Results: Coronary stenosis ≥ 50% was present in 74 patients (57.4%). Notably, patients with stenosis had significantly higher testosterone levels (6.62 ± 2.79 vs. 4.85 ± 3.50 ng/mL, p = 0.002). In univariate analysis, testosterone showed a significant association (OR 1.197 per ng/mL, OR 1.784 per SD, p = 0.003). In multivariate analysis adjusted for age, sex, diabetes mellitus, and LDL (low-density lipoprotein) cholesterol, testosterone remained independently associated (adjusted OR 2.043 per SD, 95% CI 1.221–3.420, p = 0.007), as did diabetes mellitus (OR 2.60, p = 0.032). Conclusions: Elevated serum testosterone is paradoxically associated with increased prevalence of coronary stenosis in our cohort. These findings from stable, chronic CAD patients may work fundamentally differently from what is observed in acute coronary syndromes, where stress-induced testosterone suppression may confound observed associations.