AMI and Anabolic-Androgenic Steroids: Case Report with Systematic Review

Abstract

Introduction:: Coronary artery disease (CAD) represents approximately 390 thousand deaths per year in Brazil and is associated, among other predictors, with the use of anabolic and androgenic steroids (AAS). Objective:: To analyze a clinical case of a patient who suffered AMI after abuse of AAS. A systematic literature review has been carried out to physiologically analyze the main factors that can lead to AMI with the use of these hormones. Methods:: Case Report: The EVR patient, 41 years old, denies any comorbidities or use of medications. He has been admitted to the emergency room due to typical angina-precordial pain in tightness associated with eventual back pain and paresthesia of both upper limbs, after intense physical effort at the gym, without improvement at rest, and with partial improvement after first care at the health unit. The patient was hypertensive in an emergency bed after the occurrence of ST elevation. The patient alleges the use of anabolic steroids for one month. The patient presented with obstructive atherosclerotic coronary artery disease with total occlusion of the anterior descending artery. Systematic review: A total of 89 clinical studies have been compared and submitted to eligibility analysis, with 50 studies selected, according to the PRISMA rules. Results and Conclusion:: AAS can increase protein synthesis, muscle growth, and erythropoiesis. However, abuse of AAS has a toxic cardiovascular effect, which significantly increases the incidence of cardiovascular diseases.

An ethical review on the search for performance: evidence-based nutrology and the use without indication of anabolic steroids

“…The anabolic effect of using testosterone and its analogs is mainly due to increased protein synthesis, but indirect effects are also beneficial to anabolism. Anabolic steroids are able to act as antagonists to the catabolic effects of glucocorticoids, when there is a greater amount of circulating testosterone, the balance between protein breakdown and deposit is positive even in fasting, acting positively in relation to anabolism [1].…”

“…The first studies with androgenic steroids (initially testosterone) were carried out in the year 1800, initially showing the great anabolic power that this hormone caused. been invented the fountain of youth; This belief is present even today by many laypeople and even health professionals [1].…”

“…It is not uncommon for patients to seek the use of the hormone as something miraculous that will make them reach the ideal body without much effort, even without first having adequate nutritional therapy, adequate training, and adequate sleep; some patients are not even aware that there are safe and ethical nutritional measures that can help them achieve their goals without the use of hormones [1][2][3].…”