Table 3. Meta-analyses of RCT’s that investigated the effect of TTh on CVD events. Magnitude of associations are presented as beneficial (friendly)*, detrimental (a foe)† or no effects at all (bystander)‡.
| Study author and year | Study design | Number of studies/trials | Number of participants (n) | TTh/placebo (n) | Cardiovascular events (n) | Results: only fully-adjusted multivariable models | SS or NS |
|---|---|---|---|---|---|---|---|
| Beneficial (friendly) effects* | OR’s, RR’s or HR’s that are lower or equal to 0.90 | ||||||
| Corona et al., 2014 (16) | Randomized controlled trials | 14 | 1,855 | 1,097/758 | AMI (acute myocardial infarction) (n=22) | OR =0.68; 95% CI, 0.30–1.52; P=0.34 | NS |
| 5 | 493 | 247/246 | Stroke (n=7) | OR =0.82; 95% CI, 0.24–2.83; P=0.76 | NS | ||
| Detrimental (foe) effects† | OR’s, RR’s or HR’s that are higher or equal to 1.10 | ||||||
| Haddad et al., 2007 (32) | Randomized controlled trials | 6 | 308 | 167/147 | Any CV events (n=21) | OR =1.82; 95% CI, 0.78–4.23 | NS |
| Xu et al., 2013 (33) | Randomized controlled trials | 27 | 2,994 | 1,848/1,326 | Cardiovascular related events (n=180) | OR =1.54; 95% CI, 1.09–2.18 | SS |
| Ruige et al., 2013 (34) | Randomized controlled trials | 10 | 2,130 | 1,289/841 | Cardiovascular events (n=69) | RR =1.64; 95% CI, 0.77–3.47 | NS |
| Corona et al., 2014 (16) | Randomized controlled trials | 3 | 583 | 390/193 | New heart failure (n=3) | OR =1.64; 95% CI, 0.25–10.63; P=0.60 | NS |
| 13 | 2,120 | 1,184/936 | CV mortality (n=19) | OR =1.14; 95% CI, 0.49–2.66; P=0.76 | NS | ||
| Borst et al., 2014 (35) | Randomized controlled trials | 35 | 3,703 | 2,114/1,589 | Cardiovascular related events (n=218) | RR =1.28; 95% CI, 0.76–2.13 | NS |
| Calof et al., 2005 (36) | Randomized controlled trials | 19 | 1,084 | 651/433 | All cardiovascular events (n=34) | OR =1.14; 95% CI, 0.59–2.20 | NS |
| No effects at all (bystander)‡ | Neither beneficial nor detrimental | ||||||
| Corona et al., 2014 (16) | Randomized controlled trials | 26 | 3,287 | 1,926/1,361 | MACEa: cardiovascular death, non-fatal myocardial infarction and stroke, and acute coronary syndromes and/or heart failure (n=51) | OR =1.01; 95% CI, 0.57–1.77; P=0.98 | NS |
| 31 | 3,543 | 2,070/1,473 | Overall cardiovascular events (n=209) | OR =1.07; 95% CI, 0.69–1.65; P=0.76 | NS | ||
| 15 | 1,860 | 1,111/749 | Acute coronary syndrome (n=29) | OR =0.92; 95% CI, 0.43–1.97; P=0.83 | NS | ||
| Fernández-Balsells et al., 2010 (37) | Randomized controlled trials | 7 | 1,062 | 662/400 | Myocardial infarction (n=9) | RR =0.91; 95% CI, 0.29–2.82 | NS |
*, beneficial (friendly) effects is the magnitude of association such as odd ratios (OR’s), rate ratios (RR’s), or hazard ratios (HR’s) whether they are below or equal to 0.90; †, detrimental (foe) effects if the OR’s, RR’s or HR’s are greater or equal to 1.10; ‡, no effects at all (bystander) if it is neither friendly nor foe; a, major adverse cardiovascular events (MACE): cardiovascular death, non-fatal myocardial infarction and stroke, and acute coronary syndromes and/or heart failure; RCT’s, randomized controlled trials; TTh, testosterone therapy; CVD, cardiovascular disease; SS, statistically significant; NS, not statistically significant.