Key result
Emergency CABG successfully rescues young patient with cocaine-induced LMCA thrombosis and cardiogenic shock.
Why the study?
There are no specific guidelines about treatment of thrombus formation in coronary arteries as a consequence of cocaine use, and treatment decisions require individualized approaches.
Case Report (n=1)
CABG may be a preferable and successful treatment strategy for acute left main coronary artery thrombosis due to cocaine use, given the high risk of stent thrombosis and poor medical compliance in drug abusers.
CABG success in one cocaine-related case supports feasibility; hypothesis-generating and should not change practice.
It is common knowledge that cocaine has been linked to the development of various acute and chronic cardiovascular complications including acute coronary syndromes. We present a young, male patient, drug abuser who underwent CABG due to anterolateral myocardial infarction. Our presentation is one of the very rare cases reported in literature regarding acute thrombosis of left main coronary artery related to cocaine use, in a patient with normal coronary arteries, successfully operated. Drug-abusers seem to have increased mortality and morbidity after surgery and high possibility for stent thrombosis after percutaneous coronary interventions, because of their usually terrible medical compliance and coexistent several problems of general health. There are no specific guidelines about treatment of thrombus formation in coronary arteries, as a consequence of cocaine use. So, any decision making concerning the final treatment of these patient is a unique and individualized approach. We strongly recommend that all these patients should be treated surgically, especially patients with thrombus into the left main artery.
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Apostolakis et al. (2010) conducted a case report in Acute left main coronary artery thrombosis (n=1). Cocaine use was evaluated. A 28-year-old male cocaine abuser with acute left main coronary artery thrombosis and cardiogenic shock was successfully treated with emergency coronary artery bypass grafting.
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