| Left main coronary artery occlusion with myocardial infarction in a cocaine user. Successful angioplasty with a drug-eluting stent. | |
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MedLine Citation:
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PMID: 18464951 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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François-Pierre Mongeon; Stéphane Rinfret |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: 24 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-09 Completed Date: 2008-06-12 Revised Date: 2010-09-22 |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
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Languages: eng Pagination: e30-2 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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50-36-2/Cocaine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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