Ingemar Thiblin1, Hans Garmo2, Mats Garle3, Lars Holmberg4, Liisa Byberg5, Karl Michaëlsson5, Rolf Gedeborg6. 1. Dept. of Surgical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: Ingemar.thiblin@surgsci.uu.se. 2. King's College London, Medical School, London, UK. 3. Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden. 4. Dept. of Surgical Sciences, Uppsala University, Uppsala, Sweden; King's College London, Medical School, London, UK. 5. Dept. of Surgical Sciences, Uppsala University, Uppsala, Sweden. 6. Dept. of Surgical Sciences, Uppsala University, Uppsala, Sweden; Medical Products Agency, Uppsala, Sweden.
Abstract
BACKGROUND: Non-therapeutic use of anabolic androgenic steroids (AAS) has been associated with various adverse effects; one of the most serious being direct cardiovascular effects with unknown long-term consequences. Therefore, large studies of the association between AAS and cardiovascular outcomes are warranted. We investigated cardiovascular morbidity and mortality in individuals who tested positive for AAS. METHODS AND RESULTS: Between 2002 and 2009, a total of 2013 men were enrolled in a cohort on the date of their first AAS test. Mortality and morbidity after cohort entry was retrieved from national registries. Of the 2013 individuals, 409 (20%) tested positive for AAS. These men had twice the cardiovascular morbidity and mortality rate as those with negative tests (adjusted hazard ratio (aHR) 2.0; 95% confidence interval (CI) 1.2-3.3). Compared to the Swedish population, all tested men had an increased risk of premature death from all causes (standardized mortality ratio for AAS-positive: 19.3, 95% CI 12.4-30.0; for AAS-negative: 8.3, 95% CI 6.1-11.0). CONCLUSION: Non-therapeutic exposure to AAS appears to be an independent risk factor for cardiovascular morbidity and premature death.
BACKGROUND: Non-therapeutic use of anabolic androgenic steroids (AAS) has been associated with various adverse effects; one of the most serious being direct cardiovascular effects with unknown long-term consequences. Therefore, large studies of the association between AAS and cardiovascular outcomes are warranted. We investigated cardiovascular morbidity and mortality in individuals who tested positive for AAS. METHODS AND RESULTS: Between 2002 and 2009, a total of 2013 men were enrolled in a cohort on the date of their first AAS test. Mortality and morbidity after cohort entry was retrieved from national registries. Of the 2013 individuals, 409 (20%) tested positive for AAS. These men had twice the cardiovascular morbidity and mortality rate as those with negative tests (adjusted hazard ratio (aHR) 2.0; 95% confidence interval (CI) 1.2-3.3). Compared to the Swedish population, all tested men had an increased risk of premature death from all causes (standardized mortality ratio for AAS-positive: 19.3, 95% CI 12.4-30.0; for AAS-negative: 8.3, 95% CI 6.1-11.0). CONCLUSION: Non-therapeutic exposure to AAS appears to be an independent risk factor for cardiovascular morbidity and premature death.
Authors: Nabil Ghorayeb; Ricardo Stein; Daniel Jogaib Daher; Anderson Donelli da Silveira; Luiz Eduardo Fonteles Ritt; Daniel Fernando Pellegrino Dos Santos; Ana Paula Rennó Sierra; Artur Haddad Herdy; Claúdio Gil Soares de Araújo; Cléa Simone Sabino de Souza Colombo; Daniel Arkader Kopiler; Filipe Ferrari Ribeiro de Lacerda; José Kawazoe Lazzoli; Luciana Diniz Nagem Janot de Matos; Marcelo Bichels Leitão; Ricardo Contesini Francisco; Rodrigo Otávio Bougleux Alô; Sérgio Timerman; Tales de Carvalho; Thiago Ghorayeb Garcia Journal: Arq Bras Cardiol Date: 2019-03 Impact factor: 2.000
Authors: Jason M Nagata; Rebecka Peebles; Katherine B Hill; Sasha Gorrell; Jennifer L Carlson Journal: Eat Disord Date: 2020-03-04 Impact factor: 3.663
Authors: Iain R Murray; Robert F LaPrade; Volker Musahl; Andrew G Geeslin; Jason P Zlotnicki; Barton J Mann; Frank A Petrigliano Journal: Orthop J Sports Med Date: 2016-03-31