PD50-03 CARDIOVASCULAR EVENTS AND PROSTATE CANCER DIAGNOSES IN MEN TREATED WITH TESTOSTERONE REPLACEMENT THERAPY
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy II1 Apr 2016PD50-03 CARDIOVASCULAR EVENTS AND PROSTATE CANCER DIAGNOSES IN MEN TREATED WITH TESTOSTERONE REPLACEMENT THERAPY Christopher Wallis, Kirk Lo, Yuna Lee, Yonah Krakowsky, Alaina Garbens, Raj Satkunasivam, Sender Herschorn, Ronald Kodama, Patrick Cheung, Steven Narod, and Robert Nam Christopher WallisChristopher Wallis More articles by this author , Kirk LoKirk Lo More articles by this author , Yuna LeeYuna Lee More articles by this author , Yonah KrakowskyYonah Krakowsky More articles by this author , Alaina GarbensAlaina Garbens More articles by this author , Raj SatkunasivamRaj Satkunasivam More articles by this author , Sender HerschornSender Herschorn More articles by this author , Ronald KodamaRonald Kodama More articles by this author , Patrick CheungPatrick Cheung More articles by this author , Steven NarodSteven Narod More articles by this author , and Robert NamRobert Nam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2793AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The U.S. Food and Drug Administration recently issued a caution that testosterone replacement therapy (TRT) may increase the risk of heart attack and stroke. This was based primarily on studies that had short follow-up and limited duration of treatment. We sought to determine the association of the long-term use of TRT and rates of cardiovascular events, prostate cancer, and overall mortality. METHODS We conducted a population-based, retrospective matched cohort study of patients treated from 2007-2012 in Ontario, Canada. We examined men aged 66 years and older treated with TRT and matched controls. Testosterone replacement therapy, measured as a cumulative dose exposure. We examined the following outcomes: 1) cardiovascular events (defined as myocardial infarction, cerebrovascular accidents, and venous thromboembolism); 2) prostate cancer; and 3) overall mortality. RESULTS We examined 10,311 patients treated with TRT and 28,029 matched controls. Over a median follow-up of 5.1 years, patients who had the lowest tertile of cumulative testosterone dose exposure had an increased risk of cardiovascular events (HR 1.26, 95% CI 1.09-1.46) and overall mortality (HR 1.23, 95% CI 1.14-1.33), but not prostate cancer, compared to their matched-controls. In contrast, patients who had the highest tertile of cumulative testosterone dose exposure had a decreased risk for cardiovascular events (HR 0.84, 95% 0.72-0.98), prostate cancer (HR 0.60, 95% 0.45-0.80), and overall mortality (HR 0.56, 95% 0.52-0.61), compared to their matched controls. For each endpoint, there was a statistically significant trend for decreasing risk with increasing cumulative dose exposure to testosterone (p-value for trend from <0.0001 to 0.03). CONCLUSIONS Testosterone replacement therapy appears to decrease the risk of cardiovascular events, prostate cancer diagnoses and overall mortality in a dose-responsive manner. Due to the observational nature of the data, selection bias and the health user effect must be considered. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1186-e1187 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Christopher Wallis More articles by this author Kirk Lo More articles by this author Yuna Lee More articles by this author Yonah Krakowsky More articles by this author Alaina Garbens More articles by this author Raj Satkunasivam More articles by this author Sender Herschorn More articles by this author Ronald Kodama More articles by this author Patrick Cheung More articles by this author Steven Narod More articles by this author Robert Nam More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.074 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".