{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:31:04Z","timestamp":1787671864731,"version":"build-2736575974"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Male sex and endogenous testosterone have been shown to exacerbate neutrophilia and cardiac injury in myocardial infarction (MI), raising questions about protective actions of androgen-modulating drugs in acute ST-elevation MI (STEMI).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether the use of 5-alpha reductase inhibitors (5\u03b1RIs) or androgen deprivation therapy (ADT), drugs that lower androgen actions, is associated with a reduced frequency of severe complications after percutaneous coronary intervention (PCI)\u2013treated STEMI in men.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Nationwide, registry-based cohort study of men aged 35 to 84 years with first-time STEMI treated with PCI from January 2006 to December 2022 in Sweden. Propensity score matching was used to match men treated with 5\u03b1RIs or ADT with untreated control patients. The primary outcome was a composite of mortality within 30 days and severe in-hospital complications. Data were analyzed in June 2026.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was a composite of mortality within 30 days and severe in-hospital complications (any of: cardiac arrest and resucitatation, atrioventricular block stage II or III, cardiogenic schock, new-onset atrial fibrillation or flutter, severely depressed left ventricular function, or mechanical complication). Odds ratios were calculated using conditional logistic regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In this study of men with PCI-treated STEMI, 1305 men treated with 5\u03b1RI (mean [SD] age, 74.2 [6.7] years) were matched to 6463 control patients, and 358 men treated with ADT (mean [SD] age, 76.2 [6.2] years) were matched to 1774 control patients. The odds of experiencing a severe complication were lower in men treated with 5\u03b1RIs (odds ratio [OR], 0.80; 95% CI, 0.69-0.93). No significant association was observed for men treated with ADT compared with their matched control patients (OR, 1.10; 95% CI, 0.83-1.45).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of men with PCI-treated STEMI, use of 5\u03b1RI but not ADT was associated with a lower risk of severe complications. These results warrant further research into the role of androgens and drugs that affect androgen levels in the acute phase of STEMI.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.30774","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:01:01Z","timestamp":1787670061000},"page":"e2630774","source":"Crossref","is-referenced-by-count":0,"title":["Androgen-Modulating Drugs and Severe Complications After ST-Elevation Myocardial Infarction"],"prefix":"10.1001","volume":"9","author":[{"given":"Hannah","family":"Colld\u00e9n","sequence":"first","affiliation":[{"name":"Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden"},{"name":"Department of Pharmaceuticals, Sahlgrenska University Hospital, Gothenburg, Region V\u00e4stra G\u00f6taland, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina E.","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Department of Food and Nutrition and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Bj\u00f6rck","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Redfors","sequence":"additional","affiliation":[{"name":"Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden"},{"name":"Department of Cardiology, Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, \u00d6stra Hospital, Region V\u00e4stra G\u00f6taland, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Tivesten","sequence":"additional","affiliation":[{"name":"Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden"},{"name":"Department of Endocrinology, Sahlgrenska 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