SAT-279 The Effect of Chronic 5-alpha Reductase Inhibition on Clinically Apparent and Silent Cardiovascular Events

Abstract Disclosure: R.S. Wi: None. L. Calaza: None. M. Torosoff: None. Background: Chronic administration of 5-alpha reductase inhibitor finasteride has been shown to decrease cholesterol levels, but the impact of finasteride on cardiovascular events remains under-explored. Methods: This retrospective, IRB approved study included 150 men with benign prostatic hyperplasia: 50 treated with finasteride and 100 controls. The follow-up time interval was 60.3 +/- 38 months. Clinical CV events including myocardial infraction, angioplasty, coronary artery bypass surgery, and peripheral vascular disease were collected from the charts. Pre- and post-finasteride ECGs were compared for the presence of new q-waves and/or LBBB. Prevalence of composite cardiovascular events included myocardial infarction, angioplasty, coronary artery bypass surgery, peripheral vascular disease revascularization, and new q-waves and LBBB were compared between finasteride and control groups. Results: Mean age at the time of first testing was 64.9 +/- 6.2 years, with no significant differences between groups in the histories of smoking (14%); hyperlipidemia (71.5%), diabetes (26.5%), hypertension (65.5%), coronary artery disease (20%), peripheral vascular disease (5.5%), and carotid disease (4.5%).Prevalence of myocardial infarction, angioplasty, coronary artery bypass surgery, peripheral vascular disease revascularization during follow-up were not decreased in finasteride group (5/50, 10% vs 8/100, 8% in controls, p=0.682). However, there was a trend of increased prevalence of new q-waves or LBBB in finasteride treated subjects (7/27, 25.9% in finasteride group vs 6/46 13% in controls, p=0.165). Similarly, there was a trend of increased prevalence of clinical and ECG events in finasteride treated subjects (11/50, 22% vs 12/100, 12% in controls, p=0.109)Conclusion: This observational data suggests that while finasteride treatment may affect lipid panels, it does not decrease prevalence of clinically apparent cardiac events and new ECG abnormalities suggestive for prior myocardial infarction. A dissociation between cholesterol lowering and lack of CV event reduction with finasteride should be considered in CV risk assessment and management. Presentation: Saturday, July 12, 2025