Testosterone Level and Coronary Artery Disease in Iranian Men; a Systematic Review

Coronary artery disease (CAD) is among the most common cardiovascular diseases (CVDs),caused by the formation of plaques of lipids, calcium, and inflammatory cells. In Iran, CAD is responsible forabout 50% of all deaths per year. There is also a probability of the role of androgens deficiency in CAD in men.We aimed to systematically review all the related original studies to achieve an overall insight into the associa-tions of testosterone and CAD in Iranian men.

MedLine, Web of Science, Scopus, and Google scholardatabases were searched from inception to January 2021. All types of studies on Iranian men older than 40 yearsof age, reporting results of comparing testosterone in normal individuals and those with CAD were included.The main findings of the articles were compared to achieve an overall statement.

Ultimately, six studieswere included. Most (66.7%) had directly stated that lower levels of testosterone are associated with CAD or thelevel of testosterone is lower in patients with proven CAD. Among them, in 3 (50%) studies, the mean age of theparticipants had no significant difference between patients with CAD and the normal group.

It isclear that low testosterone level is associated with increased risk of cardiovascular events but it is not definitelydetermined whether it is independent of age in Iranian men. Further well-designed studies are needed to clearlyexclude all confounding variables including age and show the net effect of testosterone on CAD.