Serum Testosterone Level on Angiographic Complexity of Coronary Lesions in Premature Ischemic Egyptian Males

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. While traditionally associated with older populations, there is a growing incidence of premature CAD.

Testosterone, the primary male sex hormone, exerts various physiological effects beyond its role in reproductive function. It influences muscle mass, fat distribution, insulin sensitivity, and vascular tone. Low testosterone levels have been associated with adverse metabolic profiles, including increased adiposity, dyslipidemia, and insulin resistance, all of which are established risk factors for atherosclerosis. Furthermore, testosterone deficiency has been linked to endothelial dysfunction, a critical early event in the development of atherosclerotic plaques.

Inclusion criteria

• Male patients aged <45 years.
• Diagnosed with premature ischemic heart disease.
• Undergoing elective coronary angiography for suspected coronary artery disease (CAD) .

Exclusion criteria

• History of acute coronary syndrome within the preceding 3 months.
• Prior diagnosis of hypogonadism or history of testosterone replacement therapy or anabolic steroid use.
• Active neoplasm or history of chemotherapy.
• Known hepatic cirrhosis, chronic kidney disease, or end-stage renal disease.
• Use of medications known to affect sex hormone levels (e.g., spironolactone, ketoconazole).
• Endocrine disorders such as sickle cell anemia or celiac disease.