Document Detail


Influence of cocaine, ethanol, or their combination on epicardial coronary arterial dimensions in humans.
MedLine Citation:
PMID:  7763124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cocaine and ethanol are often abused concomitantly, and this combination may be more lethal than either substance alone. Although previous studies showed that cocaine causes coronary arterial vasoconstriction, the combined effect of cocaine and ethanol on the coronary vasculature in humans is unknown. Thus, we assessed the effects of intranasal cocaine, intravenous ethanol, or a cocaine-ethanol combination on heart rate, systemic arterial pressure, and coronary arterial dimensions in humans. METHODS: Thirty-four subjects with chest pain (27 men and seven women, aged 34 to 67 years) who were referred for catheterization received one of the following pharmacologic interventions: (1) intranasal (2 mL) and intravenous (5 mL/kg) saline (n = 8 [group A]); (2) intranasal cocaine (2 mg/kg) and intravenous saline (5 mL/kg) (n = 9 [group B]); (3) intranasal saline (2 mL) and intravenous 10% ethanol (5 mL/kg) (n = 9 [group C]); or (4) intranasal cocaine (2 mg/kg) and intravenous 10% ethanol (5 mL/kg) (n = 8 [group D]). Heart rate, systemic arterial pressure, left coronary arterial dimensions (by computer-assisted quantitative angiography), as well as blood cocaine, ethanol, and cocaine metabolite concentrations were measured before and 30, 60, and 90 minutes after initiation of the intravenous infusions. RESULTS: No hemodynamic or angiographic changes were observed in the group A (saline) subjects. In the group B (cocaine) subjects, the heart rate-systolic arterial pressure product increased by 5% and 10% at 30 and 90 minutes, respectively, and coronary arterial diameter decreased by 14% at these times. In the group C (ethanol) subjects, no hemodynamic changes were noted, but coronary arterial diameters increased by 12%, 11%, and 12% at 30, 60, and 90 minutes, respectively. In the group D (cocaine-ethanol) patients, rate-pressure product increased by 17%, 10%, and 16%, and coronary arterial diameters increased by 7%, 12%, and 13%, at 30, 60, and 90 minutes, respectively. CONCLUSION: The combination of intranasal cocaine and intravenous ethanol causes an increase in the determinants of myocardial oxygen demand. However, it also causes a concomitant increase in epicardial coronary arterial diameter.
Authors:
M J Pirwitz; J E Willard; C Landau; R A Lange; D B Glamann; D J Kessler; E H Foerster; E Todd; L D Hillis
Related Documents :
8853344 - Role of parabrachial nucleus in baroreflex-mediated coronary vasoconstriction.
2620684 - Response to histamine of the intact coronary system in an isolated rabbit heart prepara...
6661814 - Evidence that a coronary alpha-adrenergic tone limits myocardial blood flow and oxygena...
4005894 - A clinically relevant model of heart failure: effects of ticlopidine.
12218944 - Physiological assessment of the function of the ileocecal junction with evidence of ile...
2767134 - Cardiac and hemodynamic profile of the new cardiotonic agent, dpi 201-106, in the consc...
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  155     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-06-29     Completed Date:  1995-06-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1186-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / drug effects
Cineangiography
Cocaine / adverse effects*,  blood
Coronary Angiography
Coronary Vessels / drug effects*
Drug Interactions
Ethanol / adverse effects*,  blood
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Time Factors
Chemical
Reg. No./Substance:
50-36-2/Cocaine; 64-17-5/Ethanol

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


Previous Document:  Nosocomial bloodstream infections. Secular trends in rates, mortality, and contribution to total hos...
Next Document:  How are internal medicine residency journal clubs organized, and what makes them successful?