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Cocaine-induced coronary thrombosis: what is the optimal treatment strategy

Arthur Rusovici1, Santosh Varkey, Qaisra Saeed

  • 1University Hospital and New Jersey Medical School University of Medicine and Dentistry, Newark, NJ 07101, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|March 23, 2011
PubMed

Insights

Cocaine abuse can cause severe coronary artery thrombosis, leading to acute coronary syndromes. Prompt treatment with medications resolves symptoms, but stenting poses a higher risk of stent thrombosis in these patients.

Area of Science:

  • Cardiology
  • Toxicology

Background:

  • Cocaine abuse is a known risk factor for arterial thrombosis, particularly affecting the coronary arteries.
  • Acute coronary syndromes (ACS) can manifest as severe, life-threatening coronary arterial thrombosis in individuals abusing cocaine.

Observation:

  • Three cases of severe coronary arterial thrombosis occurred in cocaine abusers, presenting as ACS.
  • Thrombosis primarily affected the proximal coronary arteries, with spontaneous distal embolization observed.
  • Crucially, these thrombotic occlusions were often not associated with pre-existing atherosclerotic lesions.

Findings:

  • Treatment with thrombolytic, antithrombotic, and anti-platelet therapies led to resolution of thrombus and symptoms.
  • Percutaneous coronary intervention (PCI) with stenting is technically feasible but carries an elevated risk.

Implications:

  • Cocaine-induced coronary thrombosis requires prompt medical management.
  • The increased risk of stent thrombosis in this population necessitates careful consideration of treatment strategies.

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