Guidelines for Testosterone Therapy Post-CABG

Medication Optimization

The American College of Cardiology recommends optimizing post-CABG medications, including beta blockers (Class I recommendation), statins (Class I recommendation), ACE inhibitors or ARBs (Class I recommendation), and antiplatelet therapy, before considering testosterone therapy 1, 2, 3
The American College of Cardiology recommends avoiding initiating postmenopausal hormone therapy in women undergoing CABG (Class III: HARM recommendation) 1, 4

Consider delaying testosterone therapy initiation for at least 3-6 months post-CABG to allow for complete surgical recovery and stabilization of hormonal levels, as recommended by the American College of Cardiology 3
For patients who were on testosterone therapy before CABG, the American College of Cardiology recommends reinstituting testosterone postoperatively only once the patient is stable, and monitoring for potential cardiovascular adverse events 1

Ensure patient is clinically stable post-CABG with optimized guideline-directed medical therapy, as recommended by the American College of Cardiology 4
If proceeding with therapy, start with lower doses and monitor closely for cardiovascular adverse events, as recommended by the American College of Cardiology 3
Consider cardiology consultation before initiating therapy in this high-risk population, as recommended by the American College of Cardiology 2