Anabolic androgenic steroids use tied to impaired myocardial flow reserve persistent coronary microvascular dysfunction: JAMA

A new study published in the Journal of American Medical Association showed that young males who use or have previously used anabolic-androgenic steroids (AASs) are more likely to have a lower myocardial flow reserve when compared to those who have never used the medicines.

Although the exact mechanism of development is unknown, long-term use of anabolic androgenic steroids is linked to a significant risk of left ventricular hypertrophy, heart failure with impaired systolic function, and early abrupt death. In the men who use AAS, early and persistently decreased myocardial microcirculation may be clinically significant, a possible underlying cause of frequent and early heart illness, and a future target for treatments.

This study used cardiac rubidium 82 (82Rb) positron emission tomography/computed tomography (PET/CT) to measure myocardial flow reserve (MFR) in males who now and previously used AAS in comparison to controls who had never used AAS. This was done to evaluate coronary microcirculation.

Men who participated in recreational strength training and did not have a history of cardiovascular disease were included in this cross-sectional study based on their history of using AAS. From November 24, 2021, until August 16, 2023, the study was carried out. The MFR between the research groups was the main result of this investigation, while the coronary calcium score was the secondary result. By definition, a threshold of MFR less than 2 was used to identify impaired myocardial microcirculation, while a cutoff of MFR less than 2.5 was used to identify sub-clinically impaired microcirculation.