Key result
Intranasal cocaine constricts diseased coronary segments by ~29%, exceeding its effect on nondiseased segments.
Why the study?
Cocaine causes inappropriate coronary vasoconstriction, but its effect on vasomotor tone in diseased versus nondiseased coronary artery segments had not been assessed.
Does intranasal cocaine cause vasoconstriction in diseased and nondiseased coronary artery segments in patients with atherosclerotic coronary artery disease?
Does intranasal cocaine cause vasoconstriction in diseased and nondiseased coronary artery segments in patients with atherosclerotic coronary artery disease?
Absolute Event Rate: 29% vs 13%
p-value: p=<0.05
Cocaine induces significant coronary vasoconstriction, which is exacerbated at sites of atherosclerotic narrowing, highlighting its ischemic risk in patients with coronary artery disease.
Highlights profound ischemic risk for cocaine users with underlying CAD; extends physiological understanding of substance-induced.
Cocaine increases myocardial oxygen demand and paradoxically decreases oxygen supply by reducing coronary blood flow. Such "inappropriate" vasoconstriction also occurs with exercise, which causes intense vasoconstriction of coronary artery segments narrowed by atherosclerosis. This study was done to assess the cocaine-induced change in vasomotor tone of diseased and nondiseased coronary artery segments. In 18 patients (15 men, 3 women, aged 35 to 67 years), coronary artery areas in diseased and nondiseased segments were quantitated before and 15 min after administration of intranasal saline solution (6 patients) or cocaine (2 mg/kg body weight) (12 patients). No variables changed after intake of the saline solution. In response to cocaine, the luminal areas of diseased and nondiseased segments decreased, but the magnitude of vasoconstriction was greater in the diseased segments (mean +/- SD 29 +/- 23% versus 13 +/- 8%, p less than 0.05). Thus, cocaine causes vasoconstriction of diseased and nondiseased coronary artery segments, but its effect is particularly marked in the former.
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Flores et al. (1990) studied Atherosclerotic coronary artery disease (n=18). Intranasal cocaine vs. Intranasal saline solution was evaluated on Decrease in luminal areas of diseased versus nondiseased coronary artery segments (p=<0.05). Intranasal cocaine caused a significantly greater decrease in luminal area in diseased coronary segments compared to nondiseased segments (29% vs 13%, p<0.05).