Document Detail


Left main coronary artery occlusion with myocardial infarction in a cocaine user. Successful angioplasty with a drug-eluting stent.
MedLine Citation:
PMID:  18464951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A patient presented with acute ST segment elevation myocardial infarction following cocaine abuse. He was transferred for primary angioplasty. The emergent coronary angiography revealed acute left main coronary artery occlusion. Recanalization with balloon angioplasty was performed, followed by thrombectomy and stenting of the left main coronary artery with a paclitaxel-eluting stent. The patient recovered with a left ventricular ejection fraction of 35% at discharge. The pathophysiology of cocaine-induced myocardial infarction includes vasospasm, thrombosis and increased myocardial oxygen demand. Primary percutaneous coronary intervention allows local delivery of vasodilators and mechanical reperfusion in a timely manner. The authors argue that it is the best option for cocaine-induced ST segment elevation myocardial infarction. Recent data from randomized trials comparing bare metal and drug-eluting stents for primary percutaneous coronary intervention are discussed, as is the lack of evidence supporting the use of thrombectomy devices in acute myocardial infarction. The authors believe that primary percutaneous coronary intervention should be considered early for a patient presenting with cocaine-induced ST segment elevation myocardial infarction.
Authors:
François-Pierre Mongeon; Stéphane Rinfret
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  24     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-06-12     Revised Date:  2010-09-22    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e30-2     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angioplasty, Transluminal, Percutaneous Coronary*
Cocaine / adverse effects*
Coronary Angiography
Coronary Occlusion / chemically induced*,  radiography*,  therapy
Drug-Eluting Stents
Humans
Male
Myocardial Infarction / chemically induced*,  radiography,  therapy
Chemical
Reg. No./Substance:
50-36-2/Cocaine
Comments/Corrections

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


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