A 29-year-old man with about two years of nonmedical testosterone and stanozolol use presented with an anterior STEMI due to thrombotic occlusion of the mid-LAD, with marked atherogenic dyslipidemia and persistent LV dysfunction; AAS exposure may have contributed to accelerated atherosclerosis and coronary thrombosis in a susceptible young individual, but alternative causes of very young MI should be systematically considered.
A 29-year-old man with no known medical history and about two years of nonmedical testosterone and stanozolol use presented with an anterior STEMI.
Emergency coronary angiography showed thrombotic total occlusion of the mid-left anterior descending artery, which was treated with primary PCI.
The patient developed Killip class II acute heart failure requiring temporary CPAP and inotropic support, with markedly reduced LVEF.
Admission labs showed marked atherogenic dyslipidemia.
LDL cholesterol fell substantially at one month after statin therapy and reported AAS discontinuation, but LVEF did not recover by three months.
The authors conclude AAS exposure may have contributed to accelerated atherosclerosis and coronary thrombosis in a susceptible young individual, while stressing that other causes of very young MI must be considered.
This case report describes a 29-year-old man with no known medical problems who had used testosterone and stanozolol (anabolic steroids) without medical supervision for about two years. He came to the hospital with chest pain and was found to have a major heart attack caused by a blood clot completely blocking a key artery on the front of the heart. Doctors opened the artery with a stent procedure, but he developed heart failure needing breathing support and medications to help the heart pump. His blood tests showed very high LDL ("bad") cholesterol and low HDL ("good") cholesterol, and scans showed milder plaque buildup in other arteries. After starting a statin and reportedly stopping steroids, his LDL dropped from 250 to 85 mg/dL within a month. However, his heart's pumping function stayed low (about 30%) at three months, although he was clinically stable. This research suggests that long-term nonmedical anabolic steroid use may contribute to early artery disease and clotting, potentially leading to heart attacks in very young people. Because this is a single case, it cannot prove steroids caused the event, and the authors emphasize that other causes of heart attacks in young people, such as inherited cholesterol problems, should also be looked for.
Boladan A, Şeker O, Savaş G, Eren S. (2026). Very Young ST-Segment Elevation Myocardial Infarction Associated With Chronic Nonmedical Anabolic-Androgenic Steroid Use: A Case Report.. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. https://doi.org/10.5543/tkda.2026.65746