Characteristics and outcome of patients with heart failure due to anabolic-androgenic steroids

Abstract

Objectives. The objective of the study was to analyse the outcome of patients with advanced heart failure due to abuse of anabolic–androgenic steroids. Design. A retrospective chart review of patients admitted or referred for advanced heart failure, due to anabolic–androgenic steroid abuse, in the period 2009–2013 was performed. Results. In 6 of 9 patients (median age: 31, all males) referred in the study period, some potential for recovery of left ventricular (LV) function was seen (P < 0.002), with a maximal improvement in LV ejection fraction reached within 6 months of treatment with angiotensin-converting enzyme inhibitors and beta-blockers. The remaining 3 patients required implantation of a LV assist device (LVAD) and were listed for heart transplantation. No recovery of LV function in the patients treated with assist device was seen. Conclusion. Anabolic–androgenic steroid-induced advanced heart failure is generally not a reversible condition. If diagnosed in the early stages some recovery of ventricular function is possible, but the long-term prognosis is uncertain. Likely, a substantial proportion of patients will eventually require LVADs or cardiac transplantation.