Document Detail


Increased prevalence of coronary artery aneurysms among cocaine users.
MedLine Citation:
PMID:  15883217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cocaine abuse has been implicated in multiple cardiovascular complications. Coronary artery aneurysms (CAAs) and ectasia occur in 0.2% to 5.3% of patients referred for angiography and are associated with atherosclerosis, Kawasaki's disease, and several rare disorders. After observing CAAs in multiple young cocaine users, we investigated the prevalence of CAAs among cocaine users undergoing coronary angiography. METHODS AND RESULTS: Clinical and angiographic characteristics of 112 consecutive patients with a history of cocaine use and coronary angiography were compared with a control group of similar age and risk factors from an existing angiographic database over the same time period. Coronary angiograms were independently read by 3 reviewers blinded to cocaine use. Cocaine users were young (mean age, 44 years), predominantly male (80%), and cigarette smokers (95%). Control patients had higher rates of diabetes (33%) and more severe coronary artery disease (P=0.01). Previous myocardial infarction was common in both groups (45% of cocaine users, 38% of control patients). Despite the frequent history of myocardial infarction among cocaine users, 48% had nonobstructive coronary artery disease. Among cocaine users, 34 of 112 (30.4%) had CAAs compared with 6 of 79 (7.6%) in the control group (P<0.001). Cocaine use was a strong predictor of CAA by univariate and multivariate analyses. CONCLUSIONS: This is the first description of an association between cocaine use and CAA. The prevalence of CAA among cocaine users was higher than expected (30.4%), given such a young cohort. Cocaine use may predispose to the formation of CAA, which may in turn be a contributing factor to myocardial infarction.
Authors:
Aaron Satran; Bradley A Bart; Christopher R Henry; M Bilal Murad; Sumaiya Talukdar; Daniel Satran; Timothy D Henry
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Publication Detail:
Type:  Journal Article     Date:  2005-05-09
Journal Detail:
Title:  Circulation     Volume:  111     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-17     Completed Date:  2005-12-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2424-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and Division of Cardiology, Hennepin County Medical Center, Minneapolis, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Case-Control Studies
Cocaine / adverse effects
Cocaine-Related Disorders / complications*
Coronary Aneurysm / chemically induced*,  epidemiology*
Coronary Angiography
Coronary Artery Disease
Dilatation, Pathologic
Female
Humans
Male
Middle Aged
Myocardial Infarction
Prevalence
Chemical
Reg. No./Substance:
50-36-2/Cocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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