Anabolic androgenic steroid-induced cardiomyopathy, stroke and peripheral vascular disease

Youssef, Maged Y Z; Alqallaf, Ahmed; Abdella, Nabila

doi:10.1136/bcr.12.2010.3650

Cited by 27 publications

(17 citation statements)

References 10 publications

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“…Surgery performed. [150]CanadaCRStroke. Upon readmission 3 years later, diffused distal arterial thrombosisMedical therapy [151]KuwaitCRCardiomyopathy, stroke and peripheral vascular diseaseMedical therapy [152]PortugalCRSevere toxic cardiomyopathy.Medical therapy [153]USACRMyocardial infarctionMedical therapy [154]TurkeyCRMyocardial infarctionMedical therapy [155]GreeceCRMyocardial infarctionMedical therapy [156]USACRAcute myocardial infarction and polycythaemiaSurgery, medical therapy, phlebotomy. [157]PortugalCRMyocardial infarctionMedical therapy. [158]TurkeyCRAcute inferior myocardial infarction, renal infarctionMedical therapy, surgery [159]USACRAcute myocardial infarctionMedical therapy, rehabilitation [160]USACRMyocardial infarctionMedical therapy [161]AustraliaCRPersistent atrial fibrillationElectrical cardioversion, medical therapy. [162]GermanyCRSevere coronary heart diseaseSurgery, medical therapy [163]UKCRCoronary thrombusMedical therapy [164]USACRCardiomyopathy, severe systolic dysfunction and Class IV heart failure.Medical therapy and device implementation until discharge. [165]USACRCardiomyopathy, acute systolic heart failure.Medical therapy, instruction not to use AAS. [166]FinlandCSCardiac hypertrophySurgery, medical therapy. In one...…”

Section: Resultsmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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Background: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems.Methods: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. Results: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided.Conclusion: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health-or drug-related journals, will support development of the evidence base.

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Section: Resultsmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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“…Damage to the cardiovascular system may also remain masked and may not manifest to a significant degree until later in life (Reza, Ågren, & Thiblin, ), although there is mounting evidence to link anabolic androgenic steroid‐associated cardiovascular damage and thrombosis with cerebrovascular accident in younger anabolic androgenic steroid users (Cooper, Reeve, & Doherty, ; Shimada et al, ; Youssef, Alqallaf, & Abdella, ). Accounts of alterations and effects on the cardiovascular system are somewhat inconsistent.…”

Section: Harms Of Anabolic Androgenic Steroid Usementioning

confidence: 99%

Anabolic androgenic steroid abuse in the United Kingdom: An update

Mullen

Whalley

Schifano

et al. 2020

British J Pharmacology

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Anabolic androgenic steroids (AASs) are prescribed for medical conditions related to low testosterone. Abuse of AASs has surged as they become recognised as potent image enhancement drugs. The primary goal of most abusers is to obtain a more attractive outward appearance. Abuse is complex. There are a vast range of AAS substances illegally available, the nature of their true composition is difficult to evaluate.Users follow dosing patterns which incorporate a number of different AASs, in addition to other pharmaceutical substances believed to complement the desired physical effects or manage unwanted effects. Animal work and medical case reports suggest potential to cause serious hepatotoxicity, plus possible neurotoxicity, nephrotoxicity and damage to the cardiovascular and reproductive systems. As the long-term AASs users reach maturity, further controlled experimentation, with larger sample sizes, is required. Data gathering should be directed towards the most vulnerable group of AAS users, females and adolescent boys.

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“…This could predispose to the development of coronary vasospasm [140]. Fortunately, the effects of lipids appear to be reversible [141].…”

Section: Stroke Linked To Illicit Drugs Of Abusementioning

confidence: 99%

A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse

Tsatsakis

Docea

Calina

et al. 2019

JCM

107

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Drugs of abuse are associated with stroke, especially in young individuals. The major classes of drugs linked to stroke are cocaine, amphetamines, heroin, morphine, cannabis, and new synthetic cannabinoids, along with androgenic anabolic steroids (AASs). Both ischemic and hemorrhagic stroke have been reported due to drug abuse. Several common mechanisms have been identified, such as arrhythmias and cardioembolism, hypoxia, vascular toxicity, vascular spasm and effects on the thrombotic mechanism, as causes for ischemic stroke. For hemorrhagic stroke, acute hypertension, aneurysm formation/rupture and angiitis-like changes have been implicated. In AAS abuse, the effect of blood pressure is rather substance specific, whereas increased erythropoiesis usually leads to thromboembolism. Transient vasospasm, caused by synthetic cannabinoids, could lead to ischemic stroke. Opiates often cause infective endocarditis, resulting in ischemic stroke and hypereosinophilia accompanied by pyogenic arthritis, provoking hemorrhagic stroke. Genetic variants are linked to increased risk for stroke in cocaine abuse. The fact that case reports on cannabis-induced stroke usually refer to the young population is very alarming.

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Anabolic androgenic steroid-induced cardiomyopathy, stroke and peripheral vascular disease

Cited by 27 publications

References 10 publications

Treatments for people who use anabolic androgenic steroids: a scoping review

Treatments for people who use anabolic androgenic steroids: a scoping review

Anabolic androgenic steroid abuse in the United Kingdom: An update

A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse

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