Cocaine and Coronary Artery Thrombosis
Authors: Aaron D. Kugelmass, J. Anthony Ware
Journal: Annals of Internal Medicine (1992)

Letters1 May 1992Cocaine and Coronary Artery ThrombosisAaron D. Kugelmass, MD, J. Anthony Ware, MDAaron D. Kugelmass, MD, J. Anthony Ware, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-9-776_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:We, like Minor and colleagues (1), have noted the apparently high incidence of thrombotic occlusion of coronary arteries lacking angiographically demonstrable lesions among the reported cases of cocaine-induced myocardial infarction. Cocaine might activate platelets or enhance activation by physiologic mediators, even though most local anesthetics inhibit platelet activation. In support of this theory, Minor and coworkers (1) cited in-vitro studies conducted by Togna and colleagues (2), in which low concentrations of cocaine reduced the threshold at which exogenous arachidonic acid induced platelet aggregation and thromboxane B2synthesis. These studies were performed in platelet-rich rabbit plasma, but platelet...References1. Minor R, Scott B, Brown D, and Winniford M. Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991;115:797-806. LinkGoogle Scholar2. Togna G, Temposta E, Togna A, Dolci N, Cebo B, and Caprino L. Platelet responsiveness and biosynthesis of thromboxane and prostacyclin in response to in vitro cocaine treatment. Haemostasis. 1985;15:100-7. CrossrefMedlineGoogle Scholar3. Ware J, Johnson P, Smith M, and Salzma E. The effect of common agonists on cytoplasmic ionized calcium concentration in platelets; measurements with quin2 and sequorin. J Clin Invest. 1986;77:878-86. CrossrefMedlineGoogle Scholar4. Santos M, Valles J, and Marcus A. Enhancement of platelet reactivity and modulation of elcosanoid production by intact erythrocytes. J Clin Invest. 1991;87:571-80. CrossrefMedlineGoogle Scholar5. Shattil S, Cunningham M, and Hoxie J. Detection of activated platelets in whole blood using activation-dependent monoclonal antibodies and flow cytometry. Blood. 1987;70:307-15. CrossrefMedlineGoogle Scholar1. Minor R, Scott B, Brown D, and Winniford M. Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991;115:797-806. LinkGoogle Scholar2. Rubinstein I, Yong T, Rennard S, and Mayhan W. Cigarette smoke extract attenuates endothelium-dependent arteriolar dilatation in vivo. Am J Physiol. 1991;261:H1913-H1918. MedlineGoogle Scholar3. Winniford M, Wheelan K, and Kremers M. Smoking-induced coronary vasoconstriction in patients with atherosclerotic coronary artery disease: evidence for adrenergically mediated alterations in coronary artery tone. Circulation. 1986;73:662-7. CrossrefMedlineGoogle Scholar4. Quillen J, Lopez J, Rossen J, Talman C, and Winniford M. Cigarette smoking produces constriction of large coronary arteries in humans [Abstract]. J Am Coll Cardiol. 1991;17:173A. CrossrefGoogle Scholar5. Minor R, Oskarsson H, Quillen J, Rossen J, and Winniford M. Intracoronary phentolamine reverses cigarette smoking-induced coronary vasoconstriction in humans [Abstract]. J Am Coll Cardiol. 1992;19 [In press]. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Aaron D. Kugelmass, MD; J. Anthony Ware, MDAffiliations: Beth Israel Hospital Harvard Medical School Boston, MA 02215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEffect of serotonin on platelet function in cocaine exposed bloodCardiac irritability and myocardial infarction in a 13-year-old girl following recreational amphetamine overdoseEffects of Cocaine on Human Platelet Aggregation In VitroActivation of human platelets by cocaine. 1 May 1992Volume 116, Issue 9Page: 776-777KeywordsCocaineCoronary arteriesLesionsMyocardial infarctionPlatelet activationPlatelet aggregationPlateletsRabbitsThrombosisThromboxane ePublished: 1 December 2008 Issue Published: 1 May 1992 PDF downloadLoading ...