Key result
Endogenous testosterone shows no association with mortality in men with established CVD.
Why the study?
Are higher levels of endogenous sex steroid hormones and sex hormone binding globulin associated with reduced risk of all-cause and cardiovascular mortality in patients with established cardiovascular disease?
Meta-Analysis (n=5,981)
Yes
Are higher levels of endogenous sex steroid hormones and sex hormone binding globulin associated with reduced risk of all-cause and cardiovascular mortality in patients with established cardiovascular disease?
Answers are grounded in this paper and cite their sources.
This systematic review and meta-analysis found no significant association between endogenous total testosterone levels and all-cause or cardiovascular mortality in men with established CVD, while highlighting a severe lack of evidence in women.
Background: Endogenous sex steroid hormones are involved in numerous regulatory mechanisms of the cardiovascular system and their imbalances are frequently observed in patients with established cardiovascular disease (CVD). However, their prognostic significance for mortality remains unclear. This study aims to systematically synthesize existing research and quantify the association between endogenous sex steroid hormones, sex hormone binding globulin (SHBG), and the risk of all-cause and cardiovascular mortality in individuals with established CVD. Methods: Six bibliographic databases were systematically searched. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model, comparing the highest versus lowest levels of sex hormones/SHBG. The risk of bias was evaluated using the ROBINS-E tool (Risk Of Bias In Non-randomized Studies - of Exposures). Results: Twelve studies with a total of 5,981 patients with established CVD were included. No significant association was found between endogenous total testosterone and risk of all-cause ((HR (95%CI): 0.78 (0.56 to 1.09), n= 5 studies) or CVD (HR (95%CI): 1.30 (0.28 to 6.01), n= 3) mortality in men. Most studies (seven out of twelve studies) were classified as having a high risk of bias, particularly due to confounding. Conclusions: We found no evidence for an association between endogenous sex hormones and mortality outcomes in patients with CVD. This study underscored the lack of sufficient evidence on this topic, especially concerning women. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022329605, identifier CRD42022329605.
No takes yet. Share an insight, caveat, or question.
Amiri et al. (2026) conducted a meta-analysis in Established cardiovascular disease (including heart failure, acute coronary syndrome, acute myocardial infarction, acute stroke, atherosclerotic CVD, and ischemic heart disease) (n=5,981). Highest levels of endogenous sex steroid hormones (primarily total testosterone) and sex hormone binding globulin (SHBG) vs. Lowest levels of endogenous sex steroid hormones and SHBG was evaluated on All-cause mortality in men with established CVD (highest vs. lowest total testosterone) (HR 0.78, 95% CI 0.56-1.09). Endogenous total testosterone was not associated with all-cause mortality or cardiovascular mortality in men with established CVD.
Synapse has enriched 10 related papers. Consider them for comparative context: