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

2018 ◽  
Vol 44 (08) ◽  
pp. 734-746 ◽  
Author(s):  
Anna-Marie Münster ◽  
Jørgen Gram ◽  
Johannes Sidelmann ◽  
Simon Chang
Keyword(s):  
Cardiovascular Risk ◽  
Wide Spectrum ◽  
Case Reports ◽  
Coagulation Factors ◽  
Epidemiological Studies ◽  
Anabolic Androgenic Steroid ◽  
Risk Markers ◽  
Androgenic Steroid ◽  
Thrombosis Risk ◽  
Increased Risk

AbstractAnabolic 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.

scholarly journals Vitamin D and Cardiovascular Risk: Which Implications in Children?

2020 ◽  
Vol 21 (10) ◽  
pp. 3536 ◽  
Author(s):  
Silvia Savastio ◽  
Erica Pozzi ◽  
Francesco Tagliaferri ◽  
Roberta Degrandi ◽  
Roberta Cinquatti ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cardiovascular Risk ◽  
Pediatric Patients ◽  
Cardiovascular Effects ◽  
Vitamin D Supplementation ◽  
Risk Markers ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Lipid Parameters

Vitamin D (25OHD) pleiotropic effects are widely recognized and studied. Recently, vitamin D cardiovascular effects are gaining interest, especially in children, although the studies present conflicting data. Some randomized controlled trials (RCTs) have demonstrated that cardiovascular risk markers, such as lipid parameters, inflammation markers, blood pressure, and arterial stiffness, are unaffected by vitamin D supplementation. By contrast, other studies show that low vitamin D levels are associated with higher risk of cardiovascular disease (CVD) and mortality, and support that increased risk of these diseases occurs primarily in people with vitamin D deficiency. An update on these points in pediatric patients is certainly of interest to focus on possible benefits of its supplementation.

scholarly journals Effects of Olive Oil Consumption on Cardiovascular Risk Factors in Patients with Fibromyalgia

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 918 ◽  
Author(s):  
Alma Rus ◽  
Francisco Molina ◽  
María Josefa Martínez-Ramírez ◽  
María Encarnación Aguilar-Ferrándiz ◽  
Ramón Carmona ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Olive Oil ◽  
Cardiovascular Risk Factors ◽  
Virgin Olive Oil ◽  
Extra Virgin Olive Oil ◽  
Risk Markers ◽  
Oil Consumption ◽  
Distribution Width ◽  
Increased Risk

We have recently reported that patients with fibromyalgia (FM) may be at increased risk for cardiovascular disease. Olive oil reportedly has cardioprotective effects. We examined the influence of olive oil consumption on cardiovascular risk factors in FM. This preliminary study was performed on blood samples of women with FM who consumed 50 mL of organic olive oil daily for 3 weeks. Patients were randomized into two groups: 15 women ingested extra virgin olive oil (EVOO) and 15 refined olive oil (ROO). Cardiovascular risk markers were measured at baseline (pre measure) and after consumption of olive oil (post measure). Red blood cell count and erythrocyte sedimentation rate (ESR; both p < 0.05) declined significantly post-treatment in the EVOO group. Consumption of ROO increased mean platelet volume and reduced platelet distribution width (PDW), neutrophil-to-lymphocyte ratio, ESR and fibrinogen (all p < 0.05). Significant differences were found in pre–post change between the EVOO and ROO groups for cortisol and PDW (both p < 0.05). Our results have shown that consumption of olive oil may have antithrombotic and antiinflammatory properties in patients with FM, thereby improving a number of cardiovascular risk markers. Both EVOO and ROO may be useful as adjuvants for the prevention and/or treatment of cardiovascular disorders in these patients.

High Soluble P-Selectin and Low Platelet Count as Thrombosis Risk Markers in Glioma Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2985-2985
Author(s):  
Rainer Vormittag ◽  
Christine Marosi ◽  
Cihan Ay ◽  
Ralph Simanek ◽  
Ilse Schwarzinger ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Platelet Count ◽  
Cox Regression ◽  
Significant Risk ◽  
Cumulative Probability ◽  
Risk Markers ◽  
Cox Regression Analysis ◽  
Thrombosis Risk ◽  
Increased Risk ◽  
Soluble P

Abstract Abstract 2985 Poster Board II-961 Background Glioma patients are at high risk for venous thromboembolism (VTE). However, predictive laboratory parameters have not been identified. High platelet count (PLC) and increased soluble P-selectin (sP-selectin) have been reported as risk factors in cancer patients, so we investigated sP-selectin and PLC as risk markers in glioma patients. Methods The Cancer and Thrombosis Study (CATS) is a prospective observational study, whose endpoint is the occurrence of objectively confirmed VTE. sP-selectin was measured in the third week after neurosurgical intervention using a human sP-selectin Immunoassay (R&D Systems®, Minneapolis, USA). Multivariable Cox regression analysis was applied to calculate hazard ratios (HR) for VTE, including PLC, sP-selectin, age, sex and type of surgery. Results 140 patients with newly diagnosed high grade glioma were analysed (52 women; median age 54.5 years [interquartile range (IQR): 42.8-5.1]) during a median observation time of 309 (range: 3-1664) days. Twenty patients developed VTE (6 women, 14 men), of which 2 events were fatal pulmonary embolisms. The cumulative probability of VTE was 10% at six and 15% at twelve months. sP-selectin levels (ng/mL) were higher in patients with VTE compared to those without (median=51.8, IQR: 36.9–66.0 versus median=38.8, IQR: 30.7–52.1, p=0.011). Interestingly, PLC (G/l) was significantly lower in patients with (median=214, IQR: 166-248) than in those without VTE (median=255, IQR: 200-327; p=0.011). In multivariable regression analysis high sP-selectin (75th percentile: 55.1ng/mL) and low PLC (25th percentile: 198G/L) were significant risk markers of VTE (HR=3.4, 95% CI 1.3-9.0, and HR=3.3, 95% CI 1.2-8.8, respectively). Conclusion Our study revealed two strong predictive markers for VTE in glioma patients. Elevated sP-selectin is associated with a three-fold increased risk of thrombosis. In contrast to patients with other solid tumours, in glioma patients low PLC is associated with increased thrombosis risk. Disclosures: Pabinger: Amgen Inc.: Honoraria, Membership on an entity's Board of Directors or advisory committees.

scholarly journals Hemodynamic-Based Evaluation on Thrombosis Risk of Fusiform Coronary Artery Aneurysms Using Computational Fluid Dynamic Simulation Method

Complexity ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Haoran Wang ◽  
Hitomi Anzai ◽  
Youjun Liu ◽  
Aike Qiao ◽  
Jinsheng Xie ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Decision Making ◽  
Case Reports ◽  
Lumped Parameter Model ◽  
Coronary Artery Aneurysms ◽  
Thrombosis Risk ◽  
Relative Residence Time ◽  
Increased Risk ◽  
Stratification Method ◽  
Normal Diameter

Coronary artery aneurysms (CAAs) have been reported to associate with an increased risk for thrombosis. Distinct to the brain aneurysm, which can cause a rupture, CAA’s threat is more about its potential to induce thrombosis, leading to myocardial infarction. Case reports suggest that thrombosis risk varied with the different CAA diameters and hemodynamics effects (usually wall shear stress (WSS), oscillatory shear index (OSI), and relative residence time (RRT)) may relate to the thrombosis risk. However, currently, due to the rareness of the disease, there is limited knowledge of the hemodynamics effects of CAA. The aim of the study was to estimate the relationship between hemodynamic effects and different diameters of CAAs. Computational fluid dynamics (CFD) provides a noninvasive means of hemodynamic research. Four three-dimensional models were constructed, representing coronary arteries with a normal diameter (1x) and CAAs with diameters two (2x), three (3x), and five times (5x) that of the normal diameter. A lumped parameter model (LPM) which can capture the feature of coronary blood flow supplied the boundary conditions. WSS in the aneurysm decreased 97.7% apparently from 3.51 Pa (1x) to 0.08 Pa (5x). OSI and RRT in the aneurysm were increased apparently by two orders of magnitude from 0.01 (1x) to 0.30 (5x), and from 0.38 Pa−1 (1x) to 51.59 Pa−1 (5x), separately. Changes in the local volume of the CAA resulted in dramatic changes in local hemodynamic parameters. The findings demonstrated that thrombosis risk increased with increasing diameter and was strongly exacerbated at larger diameters of CAA. The 2x model exhibited the lowest thrombosis risk among the models, suggesting the low-damage (medication) treatment may work. High-damage (surgery) treatment may need to be considered when CAA diameter is 3 times or higher. This diameter classification method may be a good example for constructing a more complex hemodynamic-based risk stratification method and could support clinical decision-making in the assessment of CAA.

Male Infertility and Risk of Nonmalignant Chronic Diseases: A Systematic Review of the Epidemiological Evidence

2017 ◽  
Vol 35 (03) ◽  
pp. 282-290 ◽  
Author(s):  
Jens Bonde ◽  
Michael Eisenberg ◽  
Aleksander Giwercman ◽  
Katia Hærvig ◽  
Susie Rimborg ◽  
...  
Keyword(s):  
Male Infertility ◽  
Chronic Diseases ◽  
Animal Studies ◽  
Reference Group ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Epidemiological Evidence ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Increased Risk

AbstractThe association between male infertility and increased risk of certain cancers is well studied. Less is known about the long-term risk of nonmalignant diseases in men with decreased fertility. A systemic literature review was performed on the epidemiologic evidence of male infertility as a precursor for increased risk of diabetes, cardiovascular diseases, and all-cause mortality. PubMed and Embase were searched from January 1, 1980, to September 1, 2016, to identify epidemiological studies reporting associations between male infertility and the outcomes of interest. Animal studies, case reports, reviews, studies not providing an accurate reference group, and studies including infertility due to vasectomy or malignancy were excluded. The literature search resulted in 2,485 references among which we identified seven articles fulfilling the eligibility criteria. Of these, four articles were prospective (three on risk of mortality, one on risk of chronic diseases) and three were cross-sectional relating male infertility to the Charlson Comorbidity Index. The current epidemiological evidence is compatible with an association between male infertility and risk of chronic disease and mortality, but the small number of prospective studies and insufficient adjustment of confounders preclude strong statements about male infertility as precursor of these outcomes.

scholarly journals Sudden Cardiac Death in Anabolic-Androgenic Steroid Users: A Literature Review

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 587
Author(s):  
Marco Torrisi ◽  
Giuliana Pennisi ◽  
Ilenia Russo ◽  
Francesco Amico ◽  
Massimiliano Esposito ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Anabolic Androgenic Steroids ◽  
Pathophysiological Mechanism ◽  
Anabolic Androgenic Steroid ◽  
Sports Activity ◽  
Androgenic Steroid ◽  
Increased Risk ◽  
Androgenic Steroids

Background and objectives: Anabolic-androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its related precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders, both for aesthetic uses and as performance enhancers to increase muscle growth and lean body mass. When used illicitly they can damage health and cause disorders affecting several functions. Sudden cardiac death (SCD) is the most common medical cause of death in athletes. SCD in athletes has also been associated with the use of performance-enhancing drugs. This review aimed to focus on deaths related to AAS abuse to investigate the cardiac pathophysiological mechanism that underlies this type of death, which still needs to be fully investigated. Materials and Methods: This review was conducted using PubMed Central and Google Scholar databases, until 21 July 2020, using the following key terms: “((Sudden cardiac death) OR (Sudden death)) AND ((androgenic anabolic steroid) OR (androgenic anabolic steroids) OR (anabolic-androgenic steroids) OR (anabolic-androgenic steroid))”. Thirteen articles met the inclusion and exclusion criteria, for a total of 33 reported cases. Results: Of the 33 cases, 31 (93.9%) were males while only 2 (61%) were females. Mean age was 29.79 and, among sportsmen, the most represented sports activity was bodybuilding. In all cases there was a history of AAS abuse or a physical phenotype suggesting AAS use; the total usage period was unspecified in most cases. In 24 cases the results of the toxicological analysis were reported. The most detected AASs were nandrolone, testosterone, and stanozolol. The most frequently reported macroscopic alterations were cardiomegaly and left ventricular hypertrophy, while the histological alterations were foci of fibrosis and necrosis of the myocardial tissue. Conclusions: Four principal mechanisms responsible for SCD have been proposed in AAS abusers: the atherogenic model, the thrombosis model, the model of vasospasm induced by the release of nitric oxide, and the direct myocardial injury model. Hypertrophy, fibrosis, and necrosis represent a substrate for arrhythmias, especially when combined with exercise. Indeed, AAS use has been shown to change physiological cardiac remodeling of athletes to pathophysiological cardiac hypertrophy with an increased risk of life-threatening arrhythmias.

Infections and inflammatory diseases as risk factors for venous thrombosis

2012 ◽  
Vol 107 (05) ◽  
pp. 827-837 ◽  
Author(s):  
Hanneke J. C. Kluin-Nelemans ◽  
Karina Meijer ◽  
Y. I. G. Vladimir Tichelaar
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Inflammatory Diseases ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Virus Pneumonia ◽  
Inflammatory Bowel ◽  
Tract Infections

SummaryInflammation and venous thrombosis are intertwined. Only in the recent 15 years clinical epidemiological studies have focussed on inflammatory or infectious diseases as risk factors for venous thrombosis. Although a few reviews and many case reports or studies on these topic has been written, a review reporting relative or absolute risks for venous thrombosis has not been published yet. We performed a systematic review using Medline, Pubmed and Embase and found 31 eligible articles. Inflammatory bowel disease, ANCA-associated vasculitis, infections in general and more specifically, human immunodeficiency virus, pneumonia and urinary tract infections are associated with an increased risk of venous thrombosis.

scholarly journals Depressive symptoms and non-adherence to treatable cardiovascular risk factors’ medications in the CONSTANCES cohort

2020 ◽  
Author(s):  
Nadine Hamieh ◽  
Sofiane Kab ◽  
Marie Zins ◽  
Jacques Blacher ◽  
Pierre Meneton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Depression Scale ◽  
Population Level ◽  
Epidemiological Studies ◽  
Healthcare Database ◽  
Increased Risk

Abstract Aims Depression is associated with increased risk of cardiovascular disease (CVD) and the role of poor medical adherence is mostly unknown. We studied the association between depressive symptoms and non-adherence to medications targeting treatable cardiovascular risk factors in the CONSTANCES population-based French cohort. Methods and results We used CONSTANCES data linked to the French national healthcare database to study the prospective association between depressive symptoms (assessed at inclusion with the Center for Epidemiological Studies Depression scale) and non-adherence to medications (less than 80% of trimesters with at least one drug dispensed) treating type 2 diabetes, hypertension, and dyslipidaemia over 36 months of follow-up. Binary logistic regression models were adjusted for socio-demographics, body mass index, and personal history of CVD at inclusion. Among 4998 individuals with hypertension, 793 with diabetes, and 3692 with dyslipidaemia at baseline, respectively 13.1% vs. 11.5%, 10.5% vs. 5.8%, and 29.0% vs. 27.1% of those depressed vs. those non-depressed were non-adherent over the first 18 months of follow-up (15.9% vs. 13.6%, 11.1% vs. 7.4%, and 34.8% vs. 36.6% between 19 and 36 months). Adjusting for all covariates, depressive symptoms were neither associated with non-adherence to medications for hypertension, diabetes, and dyslipidaemia over the first 18 months of follow-up, nor afterwards. Depressive symptoms were only associated with non-adherence to anti-diabetic medications between the first 3–6 months of follow-up. Conclusion Non-adherence to medications targeting treatable cardiovascular risk factors is unlikely to explain much of the association between depressive symptoms and CVD at a population level. Clinicians are urged to search for and treat depression in individuals with diabetes to foster medications adherence.

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