Impact of Anabolic-Androgenic Steroids on Coronary Artery Disease

Anabolic-androgenic steroids (AAS), synthetic derivatives of testosterone, are misused by athletes to enhance performance despite known cardiovascular risks including dyslipidemia, hypertension, and acute myocardial infarction. A 30-year-old male with a history of AAS abuse presented with acute chest pain and was diagnosed with non-ST elevation myocardial infarction. Coronary angiography revealed intimal hyperplasia, plaque erosion, and thrombus formation in the proximal left anterior descending artery, confirmed by optical coherence tomography. He was managed with glycoprotein IIb/IIIa inhibitors, anticoagulation, and triple therapy (aspirin, clopidogrel, apixaban) and was shifted to dual therapy post discharge. Literature links AAS abuse to atherogenic, thrombogenic, and vasospastic mechanisms, increasing coronary artery disease risks. This case highlights AAS-induced coronary pathology in a young patient, emphasizing the need for awareness among athletes and clinicians to prevent life-threatening outcomes. AAS abuse can cause severe coronary artery disease. Education is critical to mitigate cardiovascular risks in young athletes.