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Cardiovascular safety of testosterone replacement therapy in men: an updated systematic review and meta-analysis.

Giovanni CoronaGiulia RastrelliClotilde SparanoValeria CarinciGianni CasellaLinda VignozziAlessandra SforzaMario Maggi
Published in: Expert opinion on drug safety (2024)
Out of 3.615, 106 studies were considered, including 8.126 subjects treated with TRT and 7.310 patients allocated to placebo. No difference between TRT and placebo was observed when major adverse CV events were considered. Whereas the incidence of non-fatal arrhythmias and AF was increased in the only trial considering CV safety as the primary endpoint, this was not confirmed when all other studies were considered (MH-OR 1.61[0.84;3.08] and 1.44[0.46;4.46]). Similarly, no relationship between endogenous T levels and AF incidence was observed after the adjustment for confounders Available data confirm that TRT is safe and it is not related to an increased CV risk.
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