The lead authors of the study are researcher Hannah Colldén and Professor Åsa Tivesten of the Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital.
Photo Credits: Malin Arnesson, Johan Wingborg
Scientific Frontline: Extended "At a Glance" Summary: Finasteride and Heart Attack Outcomes
The Core Concept: A recent registry study indicates that men taking finasteride for benign prostatic hyperplasia have a lower risk of serious complications following a severe acute heart attack (ST-elevation myocardial infarction or STEMI) treated with balloon angioplasty.
Key Distinction/Mechanism: Finasteride is a 5-alpha-reductase inhibitor that works by blocking the enzyme responsible for converting testosterone into dihydrotestosterone (a more biologically active form). Because male sex hormones like testosterone can intensify inflammation during a heart attack (which exacerbates heart damage), reducing these hormones may mitigate the severity of the inflammatory response.
Origin/History: The findings stem from a registry study utilizing the SWEDEHEART quality registry and national Swedish registers, published in August 2026 by researchers at the University of Gothenburg.
Major Frameworks/Components:
- 5-Alpha-Reductase Inhibitors: The class of drugs (including finasteride) that reduces enlarged prostates by altering hormone conversion.
- Androgen-Modulating Agents: Drugs that affect male sex hormones.
- Inflammatory Response: The mechanism by which heart damage is intensified during a STEMI, particularly when treated with balloon angioplasty.
- Complication Rates: Patients on finasteride experienced a 20.8% rate of serious complications compared to 24.3% in matched controls not taking the drug. Complications measured included cardiac arrest, severe signaling disturbances, severely impaired left ventricular function, and death within 30 days.
Branch of Science: Cardiology, Endocrinology, Pharmacology.
Future Application: While these findings do not currently alter direct patient treatment protocols for heart attacks, they open new avenues for research into how sex hormones influence cardiac events and could eventually inform new therapeutic approaches to mitigate inflammation during myocardial infarctions.
Why It Matters: Understanding the link between androgen-modulating drugs and cardiac outcomes provides critical insights into why men often suffer more extensive heart damage than women during heart attacks and highlights the significant role of hormone-driven inflammation in cardiac events.
Patients treated with medication for benign prostatic hyperplasia at the time of a severe acute heart attack experienced fewer serious complications from the attack, according to a study from the University of Gothenburg.
Men likely suffer from more extensive heart attacks than women do. Studies have shown that male sex hormones, such as testosterone, intensify inflammation during an acute heart attack and lead to a larger area of damage.
Inflammation is a key factor in the extent of heart damage when an acute heart attack is treated with balloon angioplasty, one of the most common methods for rapidly opening blocked vessels that supply blood to the heart muscle.
Protected after a Heart Attack
The registry study, published in JAMA Network Open, shows that Swedish patients treated with finasteride for benign prostatic hyperplasia faced a lower risk of serious complications following an acute heart attack compared with patients matched to be as similar as possible in all respects other than the use of this specific drug.
Finasteride belongs to the class of drugs known as 5-alpha-reductase inhibitors, which reduce the size of an enlarged prostate. The drug blocks an enzyme that converts testosterone into dihydrotestosterone, a more potent and biologically active form of testosterone.
Among those treated with finasteride, the risk of serious complications was 20.8%, compared with 24.3% among the matched controls. Serious complications included, for example, cardiac arrest, severe signaling disturbances affecting heart rhythm and pumping ability, severely impaired left ventricular function, or death within 30 days.
Greater Insight into the Impact
The link between finasteride treatment and less severe complications following a heart attack aligned with the researchers' hypothesis. However, no significant difference was observed for patients treated with hormone medication for prostate cancer.
Hannah Colldén, a pharmacist and researcher at the University of Gothenburg, commented: "This result contributes to the exciting field of research into how sex hormones can affect the heart, for instance, during a heart attack, but it has no direct impact on patient treatment at present."
The study is based on the SWEDEHEART quality registry and national registers, including all men who suffered a severe acute heart attack, specifically an ST-elevation myocardial infarction (STEMI), and underwent balloon angioplasty. Those treated with drugs affecting male sex hormones (androgen-modulating agents) were matched with similar individuals who had also suffered a heart attack but did not receive that treatment.
Published in journal: JAMA Network Open (Cardiology)
Title: Androgen-Modulating Drugs and Severe Complications After ST-Elevation Myocardial Infarction
Authors: Hannah Colldén, Christina E. Lundberg, Lena Björck, Björn Redfors, Annika Rosengren, and Åsa Tivesten
Source/Credit: Göteborgs Universitet
Edited by: Scientific Frontline
Reference Number: med082626_01