Prevention of fibrinolytic shut-down after major surgery by intramuscular stanozolol

Blamey, Stephen; McArdle, B.; P, Burns; Lowe, G. D. O.; Forbes, C.D.; Carter, D.C.; Prentice, C. R. M.

doi:10.1016/0049-3848(83)90409-7

Cited by 14 publications

(7 citation statements)

References 14 publications

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“…Intramuscular stanozolol (50 mg) admin istered prior to surgery has been shown to enhance fibrinolytic activity in the postopera tive period and to prevent fibrinolytic shut down [6], Our study demonstrates that intramuscu lar stanozolol given preoperatively, although enhancing fibrinolysis, does not effect post operative hypoxaemia. Moreover, there was no significant difference in the pattern of postoperative hypoxaemia between those pa tients who had and did not have fibrinolytic shutdown.…”

Section: Beforesupporting

confidence: 48%

“…These changes occur earlier and are more pronounced in patients who develop deep venous thrombosis [4], suggesting a possible relationship between decreased fibrinolysis and thrombosis. Ana bolic steroids such as stanozolol stimulate endogenous fibrinolysis [5,6] and therefore potentially might modify the development of postoperative microthrombosis and hypox aemia.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Fibrinolytic Stimulation by Stanozolol on Postoperative Pulmonary Complications

Cuschieri¹,

Morran²,

Lowe³

et al. 1985

Pathophysiol Haemos Thromb

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Platelet aggregation in the lungs is common following abdominal surgery and may contribute to postoperative hypoxaemia. The hypothesis that an anabolic steroid, stanozolol, by preventing fibrinolytic shutdown, would prevent postoperative hypoxaemia was tested. Fifty patients undergoing abdominal surgery were randomly allocated to receive either placebo or stanozolol. Despite preventing fibrinolytic shutdown in most patients, the use of stanozolol did not influence the extent of postoperative hypoxaemia or the incidence of postoperative pulmonary complications. These results suggest that fibrinolysis does not play a significant part in the pathogenesis of postoperative pulmonary dysfunction.

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Section: Beforesupporting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

The Effect of Fibrinolytic Stimulation by Stanozolol on Postoperative Pulmonary Complications

Cuschieri¹,

Morran²,

Lowe³

et al. 1985

Pathophysiol Haemos Thromb

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“…78,85,86,110,111 The effect of AAS on fibrinolysis was initially addressed in animal studies 112 and in several human studies using euglobulin lysis time assays. 76,78,84,110,111,113 Euglobulin fractionation of plasma facilitates the precipitation of plasminogen activators, whereas very low concentrations of fibrinolytic inhibitors are present. 114 Thus, the effect of AAS on fibrinolysis determined by euglobulin clot lysis time assays favors the effect of AAS on plasminogen activators without taking the effect on fibrinolytic inhibitors into account.…”

Section: Fibrinolysismentioning

confidence: 99%

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

Chang

Münster

Gram

et al. 2018

Semin Thromb Hemost

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Anabolic androgenic steroid (AAS) abuse surged during the 1980s and is seen in approximately 1 in 20 of all males today. A wide spectrum of AAS compounds and abuse regimens are applied and AAS abuse has been associated with an unfavorable cardiovascular profile. The aim of this review is to critique the collected data concerning effects of AAS abuse on thrombosis risk through presentation of condensed evidence from studies investigating AAS-induced changes in coagulation, fibrinolysis, and cardiovascular risk markers. AAS abuse inflicts a procoagulant distribution of cardiovascular risk markers including dyslipidemia and atherosclerosis proneness. AAS abuse overall stimulates synthesis of coagulation factors, inhibitors, and fibrinolytic proteins resulting in both increased global coagulation and stimulation of fibrinolysis. Overall, supported by many case reports and some epidemiological studies, AAS abuse is associated with an increased risk of thrombosis. However, to provide clear evidence for a causal relationship between AAS abuse and thrombosis risk, future studies need to address a range of potential biases, insufficient methodology, and other shortcomings of the current literature as highlighted in this review.

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“…During operation there is also a release of activator (20) and since the majority of post-operative thrombi are initiated in the 24 h covering the operation it is possible that release of additional plasminogen activator or prevention of the fibrinolytic shutdown might inhibit formation or extension of thrombi. There have been a number of reports of the use of the anabolic steroid, stanozolol, to increase fibrinolytic activity prior to surgery to this end (21, 22,23).DDAVP has been shown to release tissue plasminogen activator and factor VIIIR:Ag probably from vascular endothelium and has been used as a pharmacological alternative to plasma concentrates in the management of congenital factor VIII deficiencies (7) as well as a systemic stimulus to raise the fibrinolytic activity of bloo d (24,25,26). Its possible usage as a prophylactic agent has been suggested by Mannucci and Rota (27) The present study was set up to determine the effect of a preoperative infusion of DDAVP on a number of haemostatic and iib.irrolytic components.…”

Section: Discussionmentioning

confidence: 99%

The Influence of DDAVP Infusion on the Coagulation and Fibrinolytic Response to Surgery

Melissari

Paes

et al. 1986

Thromb Haemost

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SummaryThe response of components of the coagulation and fibrinolysis systems to infusion of DDAVP has been examined in patients undergoing elective surgery. In the DDAVP treated group there was a significant increase, compared to control, in plasminogen activator (by fibrin plates p <0.005, ECLT p <0.0125, by Student’s t test) before operation. No difference between groups was seen by either methods in the activator levels in samples 24 h postoperation, whereas a significant drop (p <0.002) in protein C concentration was observed at this stage in the treated group. Levels of factor VIII components were significantly higher (p <0.005) than control at all stages of operation and a significant shortening (5 sec p <0.05) of the APTT was seen at all stages (apart from 24 h samples). DDAVP infusion therefore may exacerbate the hypercoagulable state observed in surgical patients without preventing the (post-operatively) fibrinolytic shutdown. Instead, infusion tends to produce fibrinolytic depletion at the key mid-operative stage.

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Prevention of fibrinolytic shut-down after major surgery by intramuscular stanozolol

Cited by 14 publications

References 14 publications

The Effect of Fibrinolytic Stimulation by Stanozolol on Postoperative Pulmonary Complications

The Effect of Fibrinolytic Stimulation by Stanozolol on Postoperative Pulmonary Complications

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

The Influence of DDAVP Infusion on the Coagulation and Fibrinolytic Response to Surgery

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