Echocardiography shows the adverse effects of anabolic steroid use among athletes, according to research published August 29 in JAMA Network Open.
A team led by Jan Frystyk, MD, PhD, from Odense University Hospital in Denmark found that both male and female athletes who use steroids have a higher lifetime risk of coronary atherosclerosis and myocardial dysfunction.
“And athletes with anabolic androgenic steroid exposure exceeding five years showed more severe calcification,” the Frystyk team wrote.
The use of anabolic androgenic steroids is common among recreational athletes. However, the researchers noted a lack of data tying steroid use to adverse cardiovascular outcomes, especially in women.
Frystyk and colleagues used echocardiography to assess cardiovascular health in recreational athletes who use anabolic androgenic steroids. They compared results with those of athletes who do not use steroids.
The cross-sectional, single-center study included 164 participants. Of these, 80 were active steroid users (median age, 35). The steroid group included 61 men and 19 women. Of the total participants, 26 were previous steroid users and 58 did not use steroids. Median cumulative lifetime steroid use was 2.2 years for active users and 2.2 years for previous users.
While the authors did not specify which sports the athletes played, they noted that the athletes played at the recreational level.
The researchers observed no group differences when comparing the number of participants with femoral or carotid artery plaques or coronary artery calcium (CAC) scores. However, they did find a statistically significant difference in the prevalence of coronary noncalcified plaques (NCPs) between active users (n = 19, 23.8%) and nonusers (n = 6, 10.3%; p = 0.03).
The investigators also reported that athletes who used steroids had greater odds of having a positive CAC score (odds ratio [OR], 1.23; p = 0.001) and coronary NCPs (OR, 1.17; p = 0.004) and that those who used steroids for more than five years had a greater severity of calcifications (n = 94; chi-squared = 9.78; p = 0.04).
Echocardiograms showed significant links between cumulative steroid use and worse left ventricular (regression coefficient: 0.08; p = 0.002) and right ventricular (0.08; p = 0.001) global longitudinal strain.
Finally, almost all athletes (35 of 36) with more than five years of cumulative steroid use had ventricular mass greater than and left ventricular ejection fraction below the median of the normal range.
The study findings support measures to prevent anabolic androgenic steroid use by both men and women in recreational sports, the authors concluded.
Read the full study here.