Article Impact Level: HIGH Data Quality: STRONG Summary of Circulation, CIRCULATIONAHA.124.071117. https://doi.org/10.1161/CIRCULATIONAHA.124.071117 Dr. Josefine Windfeld-Mathiasen et al.
Points
- Anabolic androgenic steroid (AAS) users had significantly higher rates of cardiovascular events compared to the general population.
- AAS use was strongly linked to acute myocardial infarction (HR 3.00), coronary interventions (HR 2.95), and heart failure (HR 3.63).
- AAS users showed a higher likelihood of developing arrhythmias (HR 2.26) and venous thromboembolism (HR 2.42).
- The study found an exceptionally high risk of cardiomyopathy (HR 8.90), indicating significant structural damage to the heart.
- Given the strong association with severe cardiovascular outcomes, increased awareness and medical monitoring for AAS users are necessary.
Summary
This study investigates the cardiovascular risks associated with anabolic androgenic steroid (AAS) use by examining its incidence in a cohort of male AAS users and comparing it with a matched cohort from the general population. The cohort included 1,189 men sanctioned in an anti-doping program for AAS use in Danish fitness centers from 2006 to 2018. These individuals were matched by age and sex with 59,450 controls from the general population. Both groups were followed for an average of 11 years, with data on cardiovascular events collected from national registries.
The study found that AAS users had a significantly higher incidence of several cardiovascular events compared to the control group. Notably, AAS use was associated with an increased risk of acute myocardial infarction (adjusted hazard ratio [aHR] 3.00; 95% CI, 1.67–5.39), percutaneous coronary intervention or coronary artery bypass graft (aHR 2.95; 95% CI, 1.68–5.18), venous thromboembolism (aHR 2.42; 95% CI, 1.54–3.80), arrhythmias (aHR 2.26; 95% CI, 1.53–3.32), cardiomyopathy (aHR 8.90; 95% CI, 4.99–15.88), and heart failure (aHR 3.63; 95% CI, 2.01–6.55). However, due to a limited number of cases, outcomes for ischemic stroke and cardiac arrest could not be reported.
In conclusion, the study highlights a substantial increase in cardiovascular disease risk associated with AAS use. The findings emphasize the need for awareness and management of cardiovascular risks in AAS users, given the strong association with serious cardiovascular events.
Link to the article: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.071117
References Windfeld-Mathiasen, J., Heerfordt, I. M., Dalhoff, K. P., Trærup Andersen, J., Andersen, M. A., Johansson, K. S., Biering-Sørensen, T., Olsen, F. J., & Horwitz, H. (2025). Cardiovascular disease in anabolic androgenic steroid users. Circulation, CIRCULATIONAHA.124.071117. https://doi.org/10.1161/CIRCULATIONAHA.124.071117
