Moreover, testosterone has been used in the remedy of decreased muscle mass and bone density as nicely as anemia. The position testosterone may play in the development of cardiovascular disease has more and more turn out to be the subject of present curiosity . Anabolic androgenic steroid use has elevated over the past decade, despite its potential for antagonistic results. They continue for use by Olympic stage athletes, and have even unfold to high school stage athletes, noncompetitive bodybuilders and leisure athletes (Sullivan et al 1998; Dhar et al 2007).
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Unfortunately, the information on the utilization of high dose anabolic steroids in humans are mainly offered as case reports or small research that lack adequate management groups. In addition, the data out there within the literature does not account for the steroid sort or dose, as neither may be identified. Patients additionally may be taking concomitant stimulants, corresponding to ephedra, which may confound information and the potential for adverse events. It is probably going that the frequency of cardiac events is underreported within the medical literature. Supraphysiologic doses of anabolic-androgenic steroids , which embody more than 30 natural and synthetic derivatives of testosterone, may cause a wide spectrum of clinical sequalae.
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However, testosterone in physiologic doses may even be beneficial in patients with angina , have greater ischemic thresholds and improved high quality of life . Short-term intracoronary administration of testosterone induces coronary artery dilation and will increase coronary blood circulate in men with established coronary artery illness . Therefore, an interplay of endogenous elements of the patient’s threat profile as properly as the testosterone dosing may be issues of whether or not antagonistic events happen. Erythrocytosis has been reported as a potential impact of testosterone, which may be useful in patients with anemia. The best threat of erythrocytosis occurs with injectable types of testosterone in contrast with transdermal preparations, particularly in supraphysiologic doses. An enhance of up to 44% of the baseline hematocrit has been reported .
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We report a case of an acute ST-segment elevation myocardial infarction in a patient with traditional cardiac threat components using supraphysiologic doses of supplemental, intramuscular testosterone. In addition, this affected person additionally had polycythemia, probably secondary to high-dose testosterone. The affected person underwent successful percutaneous intervention of the right coronary artery. Physicians and patients ought to be conscious of the medical consequences of anabolic steroid abuse. Development of an atheromatous plaque perpetuates endothelial dysfunction and promotes platelet aggregation and intracoronary thrombus formation (Ajayi et al 1995; Nieminen et al 1996). Moreover, a part of endothelial dysfunction has been proposed, which can contribute to irregular vessel reactivity.
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