Androgen deficiency in elderly men with systolic chronic heart failure

Objective Several previous studies have shown androgens deficiency in men with CHF, and 2 studies on the prognostic significance of serum levels of androgens in CHF patients have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHF. Methods A total of 175 elderly (age≥60 years) men with CHF were recruited. Total testosterone (TT) and sex hormone binding globulin (SHBG) were measured, and free serum testosterone (eFT) was calculated. The median follow-up time was 1262 days. Results During follow-up 54 (30.9%) patients died. TT and eFT deficiency was found in 21.7% (38/175) and 27.4% (48/175) patients, respectively. Both TT and eFT were inversely associated with LVEF and NT-proBNP (all P<0.01). Kaplan-Meier curves for patients in low, medium and high tertiles according to TT and eFT level showed significantly different cumulative survival rate (both P<0.01 by log-rank test). However, after adjustment for clinical variables, there were no significant associations between either TT or eFT levels or survival time (OR=0.97, 95% CI, 0.84-1.12, P=0.28; and OR=0.92, 95% CI, 0.82-1.06, P=0.14, respectively). Conclusion Our study showed that although levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, they are not independent predictors for mortality.