@article{article_1782590, title={Free testosterone index and bioavailable testosterone as independent predictors of good coronary collateral circulation in CTO patients}, journal={Anatolian Current Medical Journal}, volume={7}, pages={810–817}, year={2025}, DOI={10.38053/acmj.1782590}, author={Yıldırım, Abdullah and Ardıç, Mustafa Lütfullah and Paçacı, Emre and Erdoğan, Aslan and Küçükcan, Akif and Coşkun, Mükremin and Sezici, Emre and Koca, Fadime and Özkan, Eyüp and Harbalıoğlu, Hazar and et al.}, keywords={Kronik total oklüzyon, koroner kollateral dolaşım, testosteron, biyoyararlanabilir testosteron, serbest testosteron indeksi}, abstract={Aims: Chronic total occlusion (CTO) represents a clinically important form of coronary artery disease in which collateral circulation plays a critical role in maintaining myocardial perfusion. Although testosterone has been suggested to influence vascular function and angiogenesis, the relationship between androgenic parameters and coronary collateral development remains uncertain. Methods: This cross-sectional case-control study included 230 male patients diagnosed with CTO by coronary angiography. Coronary collateral circulation was graded using the Rentrop classified categorized as good CCF (score 2–3) or bad CCF (score 0–1). Serum levels of total testosterone, free testosterone, SHBG, dehydroepiandrosterone sulfate (DHEAS), and dihydrotestosterone (DHT) were measured, and bioavailable testosterone (BioT) and free testosterone index (FTI) were calculated. Associations between androgenic parameters and collateral circulation were analyzed using correlation analysis, logistic regression, and ROC curve analysis. Results: Of the study cohort, 142 patients had good CCF and 88 had bad CCF. Patients with good CCF had higher levels of total testosterone (p <0.001), DHEAS (p=0.048), BioT (p <0.001), BioT percentage (p <0.001), and FTI (p <0.001), whereas SHBG was higher in the bad CCF group (p <0.001). Free testosterone and DHT did not differ between groups. In multivariable logistic regression, BMI (aOR=1.163, 95% CI:1.044 to 1.296, p=0.006) and FTI (aOR=1.573, 95% CI:1.345 to 1.841, p <0.001) were independently associated with good CCF. ROC analysis demonstrated strong predictive performance for FTI (AUC=0.815, 95% CI:0.727 to 0.884, p <0.001) and BioT (AUC=0.804, 95% CI:0.715 to 0.875, p <0.001), both superior to total or free testosterone. Conclusion: Serum testosterone–related indices, particularly FTI and BioT, emerged as independent predictors of good coronary collateral circulation in male patients with CTO. Incorporating these parameters into clinical evaluation may provide additional prognostic information and help guide therapeutic strategies.}, number={6}, publisher={MediHealth Academy Yayıncılık}