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- It is likely that the frequency of cardiac events is underreported within the medical literature.
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Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and high quality of life. Ajayi AAL, Mathur R, Halushka PV. Testosterone increase human platelet thromboxane A2 receptor density and aggregation responses.
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Moreover, a component of endothelial dysfunction has been proposed, which may contribute to abnormal vessel reactivity. However, testosterone in physiologic doses could even be useful 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 increases coronary blood move in males with established coronary artery disease . Therefore, an interplay of endogenous components of the patient’s threat profile in addition to the testosterone dosing may be issues of whether or not adverse events happen.
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Erythrocytosis has been reported as a possible effect of testosterone, which could be beneficial in sufferers with anemia. The greatest danger of erythrocytosis happens with injectable forms of testosterone in contrast with transdermal preparations, especially in supraphysiologic doses. An improve of as much as 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 affected person with traditional cardiac risk factors using supraphysiologic doses of supplemental, intramuscular testosterone. In addition, this patient also had polycythemia, likely secondary to high-dose testosterone. The affected person underwent profitable percutaneous intervention of the right coronary artery. Physicians and sufferers ought to pay attention to the clinical 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).
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