Cardiovascular effects of metformin and testosterone replacement therapy in older men with hormone-related cancers and cancer-free population.

Metformin use was inversely associated with composite CVD in the overall population of older men.

• Hazard Ratio = 0.72 (95% CI, 0.68 - 0.76) for the overall population
• Analysis used multivariable time-dependent Cox proportional hazard models
• Retrospective cohort of 58,028 men ≥65 years identified using SEER-Medicare 2007-2015 data
• Metformin prescriptions were ascertained from SEER-Medicare records

Metformin use was inversely associated with composite CVD in the cancer-free population.

• Hazard Ratio = 0.72 (95% CI, 0.68 - 0.76) for the cancer-free population
• This estimate was identical to the overall population result
• Analysis controlled for multivariable covariates using time-dependent Cox models

Metformin use was inversely associated with composite CVD in hormone-related cancer (HRC) survivors, with a stronger association than in the cancer-free population.

• Hazard Ratio = 0.67 (95% CI, 0.64 - 0.73) for HRC survivors
• The point estimate of 0.67 was lower than the 0.72 observed in the cancer-free population, suggesting greater risk reduction in HRC survivors
• HRC survivors were identified within the SEER-Medicare 2007-2015 dataset

Testosterone replacement therapy (TTh) use was inversely associated with composite CVD in the overall population of older men.

• Hazard Ratio = 0.82 (95% CI, 0.67 - 0.99) for the overall population
• TTh prescriptions were ascertained from SEER-Medicare records
• Analysis used multivariable time-dependent Cox proportional hazard models

Testosterone replacement therapy use was inversely associated with composite CVD in the cancer-free population.

• Hazard Ratio = 0.80 (95% CI, 0.64 - 0.99) for the cancer-free population
• The confidence interval narrowly excluded 1.00, indicating statistical significance

Testosterone replacement therapy use was inversely associated with composite CVD in hormone-related cancer survivors, with a stronger association than in the cancer-free population.

• Hazard Ratio = 0.64 (95% CI, 0.48 - 0.86) for HRC survivors
• The point estimate of 0.64 was lower than the 0.80 observed in the cancer-free population
• The confidence interval did not include 1.00, indicating statistical significance

The study examined CVD subcategories including heart failure, ischemic heart disease, peripheral arterial disease, and stroke.

• Primary outcome was incident composite CVD and CVD subcategories
• Subcategories included heart failure (HF), ischemic heart disease (IHD), peripheral arterial disease (PAD), and stroke
• The cohort consisted of 58,028 men ≥65 years from SEER-Medicare 2007-2015 data

Among older men, metformin users showed greater CVD risk reduction compared to testosterone replacement therapy users.

• Metformin overall population HR = 0.72 vs. TTh overall population HR = 0.82
• Metformin HRC survivors HR = 0.67 vs. TTh HRC survivors HR = 0.64 (comparable in HRC survivors)
• The paper states 'Metformin users showed the greatest CVD risk reduction'