Testosterone and soluble ST2 as mortality predictive biomarkers in male patients with sepsis-induced cardiomyopathy

Abstract

Sepsis-induced cardiomyopathy (SIC) is characterized by high mortality and poor outcomes. This study aimed to explore the relationship between testosterone and soluble ST2 (sST2) and all-cause mortality in patients with SIC. Clinical data from SIC patients at Renmin Hospital of Wuhan University from January 2021 and March 2023 were reviewed. Serum testosterone and sST2 were measured at admission. Kaplan–Meier analysis and receiver operative characteristic curve (ROC) were used to estimate the predictive values of testosterone and sST2 on 28 days and 90 days mortality of SIC. A total of 327 male subjects with SIC were enrolled in this study. During the 28 days and 90 days follow-up, 87 (26.6%) and 103 deaths (31.5%) occurred, respectively. Kaplan–Meier analysis showed significantly higher 28 days and 90 days survival in patients with higher testosterone and decreased sST2 levels (p < 0.001). Testosterone, sST2, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were significantly associated with 28 days and 90 days mortality (p < 0.05). Partial correlation analysis showed strong positive correlation between testosterone and left ventricular ejection fraction (LVEF) (p < 0.001), and negative correlation between testosterone and sST2 (p < 0.001), high-sensitivity troponin I (hs-TnI) levels (p < 0.001) and smoke history (p < 0.01). The concentrations of sST2 were positively related with E/e′ ratio (p < 0.001), and negatively correlated with TAPSE (p < 0.001). The combination of testosterone and sST2 enhanced the prediction of both 28 days [area under the ROC curve (AUC), 0.805] and 90 days mortality (AUC, 0.833). Early serum testosterone and sST2 levels could predict mortality of SIC independently and jointly. Further research is needed to determine the utility of biochemical markers in identifying high-risk patients with SIC.

The Inverse Association between Testosterone Replacement Therapy and Cardiovascular Disease Risk: A Systematic 25-year Review and Meta-Analysis Analysis of Prospective Cohort Studies from 1999 to 2024

“…The Inverse Association between Testosterone Replacement Therapy and Cardiovascular Disease Risk: A Systematic 20year Review and Meta-Analysis Analysis of Prospective Cohort Studies up to 2023 Author: Borges, Julian Yin Vieira M.D cardiovascular disease or risk factors [3,7,12,18,24]. Additionally, TRT was found to improve ejection fraction [15,19,23], lipid profiles [8,11,17], and other cardiovascular risk factors, such as insulin resistance [14,22] and inflammatory markers [27,28].…”

“…The pooled analysis of 15 RCTs (n = 6,872 participants) [7,14,15,18,22] showed that TRT was associated with a significant 22% reduction in the risk of major adverse…”

“…The Inverse Association between Testosterone Replacement Therapy and Cardiovascular Disease Risk: A Systematic 20year Review and Meta-Analysis Analysis of Prospective Cohort Studies up to 2023 Author: Borges, Julian Yin Vieira M.D cardiovascular events (MACE) compared to placebo (RR = 0.78, 95% CI: 0.67-0.91, p = 0.002), [4,7,14,18,22] demonstrated a substantial 3.2% improvement in ejection fraction (MD = 3.2%, 95% CI: 2.1-4.3%, p < 0.001) with TRT compared to placebo.…”

“…Other Cardiovascular Risk Factors: TRT also showed benefits in improving insulin resistance and reducing inflammatory markers. Multiple studies reported reductions in C-reactive protein (CRP) and interleukin-6 (IL-6), which are key indicators of inflammation [1,7].…”

“…• Older Men and Those with Comorbid Conditions: Subgroup analyses revealed that older men and those with existing cardiovascular conditions or metabolic syndrome experienced significant benefits from TRT in terms of reduced cardiovascular events and improved endothelial function ( [7,14,37]).…”