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Nathan Goodyear

Plasma Homocysteine Levels and Mortality in Patients with Coronary Artery Disease - NEJM - 0 views

www.nejm.org/...NEJM199707243370403

homocysteine mortality cardiovascular disease CAD risk

shared by Nathan Goodyear on 03 Aug 11 - No Cached
  • Plasma total homocysteine levels are a strong predictor of mortality in patients with angiographically confirmed coronary artery disease
  • Nathan Goodyear on 03 Aug 11
     
    elevated homocysteine strong predictor of mortality
Nathan Goodyear

Interpretation of the Coronary Artery Calcium Score in Combination with Conventional Cardiovascular Risk Factors: The Multi-Ethnic Study of Atherosclerosis (MESA) - 0 views

www.ncbi.nlm.nih.gov/...PMC3840900

calcium score coronary calcium score CVD heart health heart cardiovascular disease

shared by Nathan Goodyear on 05 Oct 17 - No Cached
  • Nathan Goodyear on 05 Oct 17
     
    A more recent article on the interpretation of the coronary calcium score.  Score alone must be taken in context with the individual.
Nathan Goodyear

Dihydrotestosterone treatment in men with coronary artery disease. II. Influence on myocardial ischemia and left ventricle. | Mendeley - 0 views

www.mendeley.com/...al-ischemia-and-left-ventricle

DHT dihydrotestosterone heart cardiac androgen male men androgens

shared by Nathan Goodyear on 24 Apr 12 - No Cached
  • Nathan Goodyear on 24 Apr 12
     
    dihydrotestosterone shown to improve cardiac function measures.
Nathan Goodyear

International Journal of Impotence Research - Low testosterone levels are associated with coronary artery disease in male patients with angina - 0 views

www.nature.com/...3901504a.html

low testosterone T CAD coronary artery disease CVD men

shared by Nathan Goodyear on 26 Apr 12 - No Cached
  • Nathan Goodyear on 26 Apr 12
     
    low Testosterone found to be associated with increased CAD in men.
Nathan Goodyear

Prognostic Influence of Increased Fibrinogen and C-Reactive Protein Levels in Unstable Coronary Artery Disease - 0 views

circ.ahajournals.org/...4204.full

fibrinogen CRP CAD coronary artery disease

shared by Nathan Goodyear on 28 Apr 12 - No Cached
  • Nathan Goodyear on 28 Apr 12
     
    fibrinogen and CRP associated with poor outcome in those individuals with CAD.
Nathan Goodyear

Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement - 0 views

www.endo-society.org/...jc-2009-2509v1.pdf

HRT BHRT hormone hormones JCEM mortality menopause women menopausal women

shared by Nathan Goodyear on 10 Jul 12 - No Cached
  • Nathan Goodyear on 10 Jul 12
     
    "...in the subgroup of women starting HRT between ages 50 and 59 or less than 10 years after menopause...reduction of overall mortality and coronary artery disease."
Nathan Goodyear

Effects of Testosterone on Coronary Vasomotor Regulation in Men With Coronary Heart Disease - 0 views

circ.ahajournals.org/...1690.full

Testosterone heart cardiovascular disease men male hormone hormones

shared by Nathan Goodyear on 03 Dec 13 - No Cached
  • Nathan Goodyear on 03 Dec 13
     
    Intracoronary Testosterone infusion of Testosterone found to increase arterial dilation and improve blood flow.
Nathan Goodyear

Testosterone Deficiency, Cardiac Health, and Older Men - 0 views

www.hindawi.com/...143763

low T Testosterone obesity type II diabetes diabetes health wellness metabolic syndrome lipids cholesterol hypogonadism TDS testicular dysgenesis syndrome men male hormone hormones prostate cancer

shared by Nathan Goodyear on 12 May 14 - No Cached
  • Studies have shown pharmacological doses of testosterone to relax coronary arteries when injected intraluminally [39] and to produce modest but consistent improvement in exercise-induced angina and reverse associated ECG changes [40]. The mechanism of action is via blockade of calcium channels with effect of similar magnitude to nifedipine
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      This directly refutes the recent studies (3) that Testosterone therapy increases cardiovascular events.
    • Nathan Goodyear
      Nathan Goodyear on 13 May 14
       
      Testosterone acts as a calcium channel blocker inducing vasodilation.
  • men with chronic stable angina pectoris, the ischaemic threshold increased after 4 weeks of TRT and a recent study demonstrates improvement continuing beyond 12 months [
  • Exercise capacity in men with chronic heart failure increased after 12 weeks
  • ...36 more annotations...
  • Studies have shown an inverse relationship between serum testosterone and fasting blood glucose and insulin levels
  • Medications such as chronic analgesics, anticonvulsants, 5ARIs, and androgen ablation therapy are associated with increased risk of testosterone deficiency and insulin resistance
  • Women with T2D or metabolic syndrome characteristically have low SHBG and high free testosterone
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      This stands in polar opposite of that with men.
  • Hypogonadism is a common feature of the metabolic syndrome
  • The precise interaction between insulin resistance, visceral adiposity, and hypogonadism is, as yet, unclear but the important mechanisms are through increased aromatase production, raised leptin levels, and increase in inflammatory kinins
  • levels of testosterone are reduced in proportion to degree of obesity
  • Men should be encouraged to combine aerobic exercise with strength training. As muscle increases, glucose will be burned more efficiently and insulin levels will fall. A minimum of 30 minutes exercise three times weekly should be advised
  • Testosterone increases levels of fast-twitch muscle fibres
  • By increasing testosterone, levels of type 2 fibres increase and glucose burning improves
  • Weight loss will increase levels of testosterone
  • studies now clearly show that low testosterone leads to visceral obesity and metabolic syndrome and is also a consequence of obesity
  • In the case of MMAS [43], a baseline total testosterone of less than 10.4 nmol/L was associated with a greater than 4-fold incidence of type 2 diabetes over the next 9 years
  • There is high level evidence that TRT improves insulin resistance
  • Low testosterone predicts increased mortality and testosterone therapy improves survival in 587 men with type 2 diabetes
  • A similar retrospective US study involved 1031 men with 372 on TRT. The cumulative mortality was 21% in the untreated group versus 10% ( ) in the treated group with the greatest effect in younger men and those with type 2 diabetes
  • the presence of ED has been shown to be an independent risk factor, particularly in hypogonadal men, increasing the risk of cardiac events by over 50%
  • A recent online publication on ischaemic heart disease mortality in men concluded optimal androgen levels are a biomarker for survival
  • inverse associations between low TT or FT (Table 2) and the severity of CAD
  • A recent 10 year study from Western Australia involving 3690 men followed up from 2001–2010 concluded that TT and FT levels in the normal range were associated with decreased all-cause and cardiovascular mortality, for the first time suggesting that both low and DHT are associated with all-cause mortality and higher levels of DHT reduced cardiovascular risk
  • TDS is associated with increased cardiovascular and all-cause mortality
  • The effect of treatment with TRT reduced the mortality rate of treated cohort (8.4%) to that of the eugonadal group whereas the mortality for the untreated remained high at 19.2%
  • hypogonadal men had slightly increased triglycerides and HDL
  • Men with angiographically proven CAD (coronary artery disease) have significantly lower testosterone levels [29] compared to controls ( ) and there was a significant inverse relationship between the degree of CAD and TT (total testosterone) levels
  • TRT has also been shown to reduce fibrinogen to levels similar to fibrates
  • men treated with long acting testosterone showed highly significant reductions in TC, LDL, and triglycerides with increase in HDL, associated with significant reduction in weight, BMI, and visceral fat
  • Low androgen levels are associated with an increase in inflammatory markers
  • In the Moscow study, C-reactive protein was reduced by TRT at 30 weeks versus placebo
  • In some studies, a decline in diastolic blood pressure has been observed, after 3–9 months [24, 26] and in systolic blood pressure
  • A decline was noted in IL6 and TNF-alpha
  • No studies to date show an increase in LUTS/BPH symptoms with higher serum testosterone levels
  • TRT has been shown to upregulate PDE5 [65] and enhance the effect of PDE5Is (now an accepted therapy for both ED and LUTS), it no longer seems logical to advice avoidance of TRT in men with mild to moderate BPH.
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      What about just starting with normalization of Testosterone levels first.
  • Several meta-analyses have failed to show a link between TRT and development of prostate cancer [66] but some studies have shown a tendency for more aggressive prostate cancer in men with low testosterone
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      And if one would have looked at their estrogen levels, I guarantee they would have been found to be elevated.
  • low bioavailable testosterone and high SHBG were associated with a 4.9- and 3.2-fold risk of positive biopsy
  • Current EAU, ISSAM, and BSSM guidance [1, 2] is that there is “no evidence TRT is associated with increased risk of prostate cancer or activation of subclinical cancer.”
  • Men with prostate cancer, treated with androgen deprivation, develop an increase of fat mass with an altered lipid profile
  • Erectile dysfunction is an established marker for future cardiovascular risk and the major presenting symptom leading to a diagnosis of low testosterone
Nathan Goodyear

Inflammation and cortisol response in coronary artery disease: Annals of Medicine: Vol 41, No 3 - 0 views

www.tandfonline.com/...07853890802508934

HPA axis HPA inflammation hormones stress cortisol CAD coronary artery disease

shared by Nathan Goodyear on 12 Oct 16 - No Cached
  • Nathan Goodyear on 12 Oct 16
     
    Inflammation disrupts HPA axis.  This is no surprise as we Know that inflammation can disrupt Testosterone in men and progesterone production in women.  This study suggests that this HPA axis disruption contributes to CAD.
Nathan Goodyear

The Effect of an EDTA-based Chelation Regimen on Patients With Diabetes Mellitus and Prior Myocardial Infarction in the Trial to Assess Chelation Therapy (TACT) | Circulation: Cardiovascular Quality and Outcomes - 0 views

circoutcomes.ahajournals.org/...CIRCOUTCOMES.113.000663

EDTA chelation diabetes MI myocardial infarction heart attack CVD cardiovascular disease heart disease coronary heart disease CAD coronary artery disease

shared by Nathan Goodyear on 05 Oct 17 - No Cached
  • Nathan Goodyear on 05 Oct 17
     
    Only abstract available here, but EDTA chelation found to reduce risk of death, reinfarction, stroke, hospitalization, angina in individuals with diabetes and prior MI from 38% to 25%.
Nathan Goodyear

HOMOCYSTEINE AND CARDIOVASCULAR DISEASE - Annual Review of Medicine, 49(1):31 - 0 views

www.annualreviews.org/...annurev.med.49.1.31

HOMOCYSTEINE cardiovascular disease CAD thromboembolism DVT artherosclerosis

shared by Nathan Goodyear on 03 Aug 11 - No Cached
  • An elevated level of total homocysteine (tHcy) in blood, denoted hyperhomocysteinemia, is emerging as a prevalent and strong risk factor for atherosclerotic vascular disease in the coronary, cerebral, and peripheral vessels, and for arterial and venous thromboembolism
  • Nathan Goodyear on 03 Aug 11
     
    elevated homocysteine increases risk for artherosclerosis, cardiovascular disease, and thromboembolism
Nathan Goodyear

American College of Cardiology Foundation | Article - 0 views

content.onlinejacc.org/...article.aspx

CoQ10 aged garlic extract AGE LP-PLA2 heart health lipoprotein-associated phospholipase A2 CAD CVD cardiovascular disease

shared by Nathan Goodyear on 15 Apr 15 - No Cached
  • Nathan Goodyear on 15 Apr 15
     
    Poster found that aged garlic extract plus CoQ10 slowed coronary artery calcification and decreased Lp-PLA2 compared to placebo.
Nathan Goodyear

Association of metabolic syndrome ... [Indian J Endocrinol Metab. 2014] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...25285291

metabolic syndrome CAD coronary artery disease cardiovascular disease CVD TNF-alpha IL-6 hsCRP insulin resistance

shared by Nathan Goodyear on 07 Oct 14 - No Cached
  • Nathan Goodyear on 07 Oct 14
     
    Metabolic Syndrome is associated with CAD.  No surprise here, but increase in # of metabolic syndrome parameters was associated with increasing % of Triple vessel disease.   No surprise that MetS was associated with TNF-alpha, IL-6, IR, and hsCRP.
Nathan Goodyear

Testosterone deficiency and cardiovascular mortality Morgentaler A, - Asian J Androl - 0 views

www.ajandrology.com/preprintarticle.asp

testosterone low t low Testosterone CVD cardiovascular mortality therapy

shared by Nathan Goodyear on 01 Dec 14 - No Cached
  • overall mortality and CV mortality were inversely associated with serum T concentrations.
  • men with low serum T, defined as < 8.7 nmol l−1 (250 ng dl−1 ), demonstrated significantly greater all-cause mortality than men with higher serum T (hazard ratio [HR]: 2.24; 95% CI: 1.41-3.57), as well as greater CV mortality
  • lower T levels were significantly associated with the presence of any CV disease
  • ...19 more annotations...
  • more than 30 years of studies suggesting that low levels of T represent an increased risk for CV and overall mortality,
  • lower serum T concentrations also are associated with CV disease, including incident coronary artery disease [17],[18],[19] and atherosclerosis,
  • the actual rate of adverse events was only half as great in the T group (123 events in 1223 men at risk = 10.1%) as in the untreated group (1587 events in 7486 men = 21.2%)
  • The study by Vigen et al. [7] has already undergone two published corrections,
  • 29 medical societies have called for retraction of the article, asserting "gross data mismanagement and contamination," that rendered the study "no longer credible
  • Mortality in T-treated men was reduced by approximately half in treated men compared with untreated men, at 10.3% versus 20.7%, respectively
  • The mortality rate for men who received TTh was 3.4 deaths per 100 person-years, and 5.7 deaths per 100 person-years in untreated men
  • HR of 0.61 (95%CI: 0.42-0.88; P = 0.008), indicating a significant reduction in mortality with TTh
  • men in the highest prognostic MI risk quartile, treatment with TTh was associated with reduced risk
  • tripling in T prescriptions in the US over the last decade
  • a majority of observational studies have found that low endogenous serum T levels are associated with increased mortality.
  • Men who received TTh were able to exercise significantly longer without ischemia compared with men who received placebo
  • In men with congestive heart failure, those who received T demonstrated greater walking distance and other functional endpoints compared with those who received placebo
  • TTh has been shown uniformly and repeatedly to improve several known CV risk factors, including reduced fat mass, body fat percent, and waist circumference, and increased lean mass
  • improved glycemic control
  • reductions in insulin resistance.
  • the evidence strongly points to improved CV status with normal serum T or treatment with TTh in men with TD
  • analysis of health insurance claims data that reported a 36% increased rate of nonfatal MI in the 90d following receipt of a T prescription compared with the 12 prior months.
  • Comparison with men who received a prescription for a phosphodiesterase type 5 inhibitor (PDE5i) revealed no increased rate of MI following the prescription
  • Nathan Goodyear on 01 Dec 14
     
    Great review by Morgentaler of Testosterone and CVD.  He highlights the significant flaws in the JAMA and the NEJM articles of Testosterone therapy risks.  Morgentaler highlights the significant evidence that points to low T and increased risk of CVD. On contention I have, is Morgantaler seems to flip aside the massive uptick of Testosterone use in the US as compared to other countries.  The evidence definitely points to Testosterone therapy as being safe in those with low T, but there is definitely a problem of significant Testosterone doping that is taking place as well.
Nathan Goodyear

Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms - 0 views

eurheartj.oxfordjournals.org/...890.abstract

CAD cardiovascular disease low T Testosterone

shared by Nathan Goodyear on 21 Nov 13 - No Cached
  • Nathan Goodyear on 21 Nov 13
     
    men with CAD found to have lower Testosterone levels compared to normal control group.  
Nathan Goodyear

Abstract 3608: Lipoprotein (a) Cholesterol, But Not Lp(a) Mass, Is An Independent Predictor Of Angiographic Coronary Artery Disease And Subsequent Cardiovascular Events In Patients Referred For Coronary Angiography. -- McConnell et al. 116 (10016): II_818 - 0 views

circ.ahajournals.org/...II_818-c

Lp(a) Lp(a) mass lipoprotein(a) lipoprotein(a) mass heart health cardiovascular disease risk

shared by Nathan Goodyear on 26 Aug 14 - No Cached
  • Nathan Goodyear on 26 Aug 14
     
    Lipoprotein (a) cholesterol is a better predictor of CAD and CVD events than Lipoprotein (a) mass.
Nathan Goodyear

The Association between Premature Coronary Art... [Arch Iran Med. 2014] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...25065277

low T Testosterone low T low Testosterone free Testosterone Total Testosterone CAD coronary artery disease atherosclerosis heart disease men male hormone hormones health

shared by Nathan Goodyear on 30 Jul 14 - No Cached
  • Nathan Goodyear on 30 Jul 14
     
    Low free and Total Testosterone levels found to be associated with premature CAD in men.  Some confounders were present, which they tried to account for--this should leave some healthy questioning of this study results.  That being said, this is not the first time low T has been found to be associated with CAD in men.  This study found a statistical significant association with Free and Total Testosterone levels in young men.  Another point to consider is the Low T a cause or a biomarker and an effect of poor/declining health?  I would so more to the biomarker point.
Nathan Goodyear

Effect of oral administration of testosterone on brachial arterial vasoreactivity in men with coronary artery disease - 0 views

www.ajconline.org/...abstract

testosterone CVD CAD

shared by Nathan Goodyear on 01 Jun 13 - No Cached
  • Nathan Goodyear on 01 Jun 13
     
    physiologic replacement of testosterone shown to increase NO synthesis, increased vasorelaxation, and reduced CVD symptoms, like hypertension.
Nathan Goodyear

Acute Anti-Ischemic Effect of Testosterone in Men With Coronary Artery Disease - 0 views

circ.ahajournals.org/...1666.full

low T low Testosterone CAD CVD testosterone artery dilation heart myocardium myocardial ischemia cardiology men male hormone hormones

shared by Nathan Goodyear on 17 Jul 12 - No Cached
  • Nathan Goodyear on 17 Jul 12
     
    Testosterone shown to have vasodilatory effect in men.  In this small study, the short course of IV testosterone reduced exercise induced heart ischemia.  This was in men with pre-existing CAD.
Nathan Goodyear

Beyond the male sex hormone: deciphering the metabolic and vascular actions of testosterone - 0 views

joe.endocrinology-journals.org/...C1.full

AR androgen receptors androgen receptor testosterone androgen receptors Diabetes metabolic syndrome MetS CVD cardiovascular disease men hormone hormones male

shared by Nathan Goodyear on 08 May 13 - No Cached
  • androgen deprivation therapy results in unfavorable changes in body composition, insulin resistance, and dyslipidemia and predisposes men to develop atherosclerosis and an increased risk of cardiovascular mortality
  • The hypogonadal–obesity cycle hypothesis was originally proposed by Cohen in 1999 to explain the relationship between low testosterone levels and metabolic disease. It was based on the finding that obesity impairs testosterone levels by increasing the aromatization of testosterone to estradiol, while low testosterone levels promote increased fat deposition
  • adipocytokines contribute to low testosterone levels as well as to the processes underlying metabolic syndromes and type 2 diabetes
  • ...15 more annotations...
  • hypogonadal–obesity–adipocytokine hypothesis
  • The presence of estradiol and the adipocytokines TNF-α, IL6, and leptin (as a result of leptin resistance in obesity) inhibits the hypothalamic–pituitary–testicular axis response to decreasing androgen levels
  • An increasing number of studies have illustrated the potential for applying metabolomics to the field of androgen research
  • As early as the 1940s, the therapeutic use of testosterone was reported to improve angina pectoris in men with coronary artery disease
  • most of the epidemiological studies reported increased cardiovascular risk and mortality in men with low testosterone levels
  • long-term testosterone replacement appears to be a safe and effective means of treating hypogonadal elderly men
  • a recent interventional trial showed that testosterone treatment was associated with decreased mortality when compared with no testosterone treatment in an observational cohort of men with low testosterone levels
  • a number of short-term studies conducted support the notion that testosterone therapy reduces the cardiovascular risk
  • The majority of animal studies support the hypothesis that the actions of testosterone on vascular relaxation are both endothelium-dependent and -independent vasodilatory effects
  • Endothelial-dependent actions of testosterone increase the expression or activity of endothelial nitric oxide synthase and enhance nitric oxide production, which in turn activates cyclic guanosine monophosphate to induce vasorelaxation in smooth muscle cells
  • Endothelial-independent mechanisms of testosterone are believed to occur primarily via inhibition of voltage-operated Ca2+ channels and/or activation of K+ channels in smooth muscle cells
  • Testosterone may also inhibit intracellular Ca2+ influx via store-operated Ca2+ channels by blocking the response to prostaglandin F2α
  • testosterone has demonstrated anti-inflammatory effects to protect against atherogenesis in animal studies
  • both genomic AR activation to modulate gene transcription and non-genomic activation to modulate the rapid intracellular signaling pathways of ion channels may mediate testosterone effects on vascular function and inflammation.
  • Butenandt & Ruzicka first showed how testosterone is synthesized and responsible for masculine characteristics in the early 1930s
  • Nathan Goodyear on 08 May 13
     
    Awesome review on the current understanding of Testosterone and Diabetes, metabolic syndrome, and CVD.  This article even goes into the literature on androgen receptors.
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