{"doi":"10.1016/j.annepidem.2025.12.004","title":"Cardiovascular effects of metformin and testosterone replacement therapy in older men with hormone-related cancers and cancer-free population","abstract":"PURPOSE: This study examines the association between use of metformin and testosterone replacement therapy (TTh) with risk of cardiovascular disease (CVD) and its subcategories in the overall population, hormone-related cancer (HRC) survivors, and cancer-free population. METHODS: A retrospective cohort of 58,028 men ≥ 65 years was identified using SEER-Medicare 2007-2015 data. Metformin and TTh prescriptions were ascertained for this analysis. The primary outcome was incident composite CVD and CVD subcategories (heart failure [HF], ischemic heart disease [IHD], peripheral arterial disease [PAD], and stroke). Multivariable time-dependent Cox proportional hazard models were conducted. RESULTS: Metformin use was inversely associated with CVD in the overall population (Hazard Ratio [HR] = 0.72, 95 % CI, 0.68 - 0.76), cancer-free population (HR = 0.72, 95 % CI, 0.68 - 0.76), and HRC survivors (HR = 0.67, 95 % CI, 0.64 - 0.73). Likewise, TTh use was inversely associated with CVD in overall population (HR = 0.82, 95 % CI, 0.67 - 0.99), cancer-free population (HR = 0.80, 95 % CI, 0.64 - 0.99), and HRC survivors (HR = 0.64, 95 % CI, 0.48 - 86). CONCLUSIONS: Metformin and TTh were inversely associated with CVD among older men in the overall population, HRC survivors, and cancer-free populations. Metformin users showed the greatest CVD risk reduction. Further studies are warranted to confirm these associations.","journal":"Annals of Epidemiology","year":2025,"id":584253,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":0.0,"corpus_rank":10062,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6371,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1497532,"name":"S. Njoroge","orcid":null,"position":1,"is_corresponding":false},{"id":1497533,"name":"Anirudh S. Babu","orcid":null,"position":2,"is_corresponding":false},{"id":925832,"name":"Md Ibrahim Tahashilder","orcid":"0000-0001-8521-1461","position":3,"is_corresponding":false},{"id":1050594,"name":"Jesús Gibran Hernández‐Pérez","orcid":"0000-0002-7637-4127","position":4,"is_corresponding":false},{"id":919610,"name":"Luisa Torres‐Sánchez","orcid":"0000-0002-2902-9881","position":5,"is_corresponding":false},{"id":1435302,"name":"M. Hussain","orcid":"0009-0009-2312-8449","position":6,"is_corresponding":false},{"id":370877,"name":"Alejandro Villasante‐Tezanos","orcid":"0000-0001-5108-8637","position":7,"is_corresponding":false},{"id":369850,"name":"Ioannis Malagaris","orcid":"0000-0001-5126-2068","position":8,"is_corresponding":false},{"id":851636,"name":"Wissam Khalife","orcid":"0000-0002-2234-3552","position":9,"is_corresponding":false},{"id":339830,"name":"Yong‐Fang Kuo","orcid":"0000-0003-1927-0927","position":10,"is_corresponding":false},{"id":73780,"name":"David S. López","orcid":"0000-0002-2321-0372","position":11,"is_corresponding":false},{"id":1341138,"name":"Omer Abdelgadir","orcid":"0009-0002-6104-0156","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T02:59:11.978098Z","pmid":"41354168","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}