Rises in Hematocrit is Associated with an Increased Risk of Major Adverse Cardiac Events in Men Starting Testosterone Therapy - A Retrospective Cohort Claims Database Analysis

No AccessJournal of UrologyAdult Urology10 Nov 2023Rises in Hematocrit is Associated with an Increased Risk of Major Adverse Cardiac Events in Men Starting Testosterone Therapy - A Retrospective Cohort Claims Database Analysis Taylor P. Kohn, Pranjal Agrawal, Jesse Ory, Joshua Hare, and Ranjith Ramasamy Taylor P. KohnTaylor P. Kohn The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author , Pranjal AgrawalPranjal Agrawal The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author , Jesse OryJesse Ory Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author , Joshua HareJoshua Hare The Interdisciplinary Stem Cell Institute, Department of Medicine, Cardiology Division, Miller School of Medicine, University of Miami, Miami, Florida More articles by this author , and Ranjith RamasamyRanjith Ramasamy *Correspondence: Department of Urology, University of Miami, 1120 NW 14th St, #1551, Miami, FL 33136 (email: E-mail Address: [email protected]). Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, Florida More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003786AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Objective: Elevated hematocrit (Hct) can result in increased risk of major adverse cardiac events (MACE) in men receiving testosterone therapy (TTh). However, the impact of the magnitude of the change in Hct from baseline after starting TTh has never been assessed. Methods: To assess whether an increase in Hct after initiating TTh is associated with an increased risk of MACE within 3 and 24 months of initiating TTh, we queried the TriNetX Research network database for men over the age of 18 with Hct values obtained within 6 months before starting TTh, and who had follow-up Hct measurements within 3 and 24 months after beginning TTh from 2010-2021. Men with and without a subsequent increase in Hct after initiating TTh were propensity matched. MACE was defined as myocardial infarction, stroke, or death. Results: After matching, 10,511 men who experienced an any increase in Hct after initiating TTh and an equal number of controls who did have an increase in Hct were included. Compared to controls who did not have an increase in Hct after starting TTh, the men who had an increase in subsequent Hct had a significantly increased risk of major adverse cardiac events compared with men with no change in Hct. Conclusions: We demonstrate that increases in Hct from baseline are associated with increased risk of MACE, compared to men whose Hct remains stable while receiving TTh. Impact Statement: Clinicians should monitor Hct after initiating TTh, as large increase from baseline may be a risk factor for MACE. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.KeywordsMyocardial InfarctionTestosteroneDeathHematocritIschemic StrokeMetrics Author Information Taylor P. Kohn The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author Pranjal Agrawal The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author Jesse Ory Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author Joshua Hare The Interdisciplinary Stem Cell Institute, Department of Medicine, Cardiology Division, Miller School of Medicine, University of Miami, Miami, Florida More articles by this author Ranjith Ramasamy Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, Florida *Correspondence: Department of Urology, University of Miami, 1120 NW 14th St, #1551, Miami, FL 33136 (email: E-mail Address: [email protected]). More articles by this author Expand All Advertisement PDF downloadLoading ...