Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Chang, Simon; Münster, Anna-Marie Bloch; Gram, Jørgen Brodersen; Sidelmann, Johannes Jakobsen

doi:10.1055/s-0038-1670639

Cited by 40 publications

(26 citation statements)

References 118 publications

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“…A recent report suggested a possible correlation between AAS abuse and immunodeficiency that may be related to a mimicking action of corticosteroid activity. Moreover, this report suggested that AAS abuse should be investigated when an uncommon death occurs in immunosuppressed patients [111,112].…”

Section: Hematologic Consequencesmentioning

confidence: 94%

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

et al. 2021

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Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.

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Section: Hematologic Consequencesmentioning

confidence: 94%

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

et al. 2021

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“…Roşca et al also tested this theory with the drug nandrolone, and observed a hypercoagulable state in rats [41]. Chang et al suggested that AS use may impair synthesis of coagulation factors, inhibitors, and fibrinolytic proteins, causing a procoagulant state that may lead to myocardial infarction and other thrombotic complications [42]. Baggish et al also found that there was an increase in coronary artery plaque volume in AS users when compared to non-user, leading to rapidly progressive coronary artery disease [43].…”

Section: Sudden Cardiac Death and Asmentioning

confidence: 99%

Anabolic Steroids and Cardiovascular Outcomes: The Controversy

Perry¹,

Schuetz²,

Memon³

et al. 2020

Cureus

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Anabolic steroids (AS) are synthetic derivatives of the male sex hormone testosterone. The use of AS is not limited to bodybuilders and athletes, but non-athletes also use them. It is used to enhance athletic performance, induce muscle hypertrophy, and augment male sexual characteristics. AS use is associated with a wide range of side effects and potential cardiovascular complications. In this article, we have searched the available literature to investigate the association between AS use and cardiovascular disease (CVD). The results revealed that AS was linked to lipid metabolism derangements, hypertension, coagulation disorders, and cardiomyopathy. We concluded, based on the relevant data, that there was evidence that suggests an association with CVD, primarily myocardial infarction, fatal arrhythmias, and cardiomyopathy in AS users. The general population should be informed of the risk. Also, methods of primary and secondary prevention should be implemented to mitigate the risk of CVD secondary to AS.

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“…This causal relationship must also refer to the influence of androgen excess over the humoral system of coagulation and fibrinolysis, another subject of debate. The gathered data in this area suggest that AAS abuse induces an overactivation of the hemostatic system, with both procoagulant and fibrinolytic effects [104]. Depending on various exogenous or endogenous factors, at a certain moment the procoagulant action probably overcomes the fibrinolytic one.…”

Section: Discussionmentioning

confidence: 99%

“…A high amount of evidence suggests that hemostatic disturbances may lead to cardiovascular disease (CVD), sometimes with severe thrombotic endpoints [98][99][100][101][102]. Direct proofs of androgens' thrombogenic effects are scarce and come from animal models of thrombosis, but there is a considerable amount of indirect data emerging from studies that assess the influence of exogenous androgens on the key processes of hemostasis, such as platelet activation and aggregation (detailed in the following section of this article), or coagulation and fibrinolysis (recently and extensively reviewed) [28,103,104].…”

Section: Overview Of Thrombogenic Potential Of Exogenous Androgensmentioning

confidence: 99%

Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review

Roşca

Vlădăreanu

Mititelu

et al. 2021

JCM

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Anabolic androgenic steroids (AAS), simply called “androgens”, represent the most widespread drugs used to enhance performance and appearance in a sporting environment. High-dosage and/or long-term AAS administration has been associated frequently with significant alterations in the cardiovascular system, some of these with severe endpoints. The induction of a prothrombotic state is probably the most life-threatening consequence, suggested by numerous case reports in AAS-abusing athletes, and by a considerable number of human and animal studies assessing the influence of exogenous androgens on hemostasis. Despite over fifty years of research, data regarding the thrombogenic potential of exogenous androgens are still scarce. The main reason is the limited possibility of conducting human prospective studies. However, human observational studies conducted in athletes or patients, in vitro human studies, and animal experiments have pointed out that androgens in supraphysiological doses induce enhanced platelet activity and thrombopoiesis, leading to increased platelet aggregation. If this tendency overlaps previously existing coagulation and/or fibrinolysis dysfunctions, it may lead to a thrombotic diathesis, which could explain the multitude of thromboembolic events reported in the AAS-abusing population. The influence of androgen excess on the platelet activity and fluid–coagulant balance remains a subject of debate, urging for supplementary studies in order to clarify the effects on hemostasis, and to provide new compelling evidence for their claimed thrombogenic potential.

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Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Cited by 40 publications

References 118 publications

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

Anabolic Steroids and Cardiovascular Outcomes: The Controversy

Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review

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