The Association Between Serum Testosterone Levels and Coronary Artery Disease in Men

Background: Death due to coronary artery disease (CAD) is twice higher in men than women, and older men are more susceptible to the disease. Serum testosterone levels decrease with increasing age. Objectives: In this study, we aim to study the association between serum testosterone levels and Gensini scores in men. Methods: This cross-sectional study was conducted on 60 men above 40 years who had undergone coronary angiography. Thirty of them had normal coronary vessels, and 30 had coronary artery disease. For each group, the Gensini score was calculated. Results: Serum testosterone levels in the CAD group and the control group were 4.04 ± 2.56 and 5.59 ± 2.20 ng/mL, respectively (P < 0.05), and free testosterone levels in the CAD patients and the control groups were 7.32 ± 5.24 and 12.91 ± 3.27 pg/mL respectively (P < 0.001). Sex hormone binding globulin (SHBG) levels in the CAD and the control groups were 28.88 ± 15.30 and 38.2 ± 19.9 nmol/mL, respectively (P = 0.04). Univariate analysis showed a significant association between Gensini score and total and free testosterone levels. The receiver operating characteristic curve (ROC) showed that the cut-off point of 7.97 had a sensitivity of 73.3% and specificity of 90% in predicting a high Gensini score (AUC = 0.799, P < 0.001). Conclusions: Findings of our study demonstrated that serum free testosterone levels have a significant correlation with Gensini score and CAD severity.