Increased Prevalence of Coronary Artery Aneurysms Among Cocaine Users

Satran, Aaron; Bart, Bradley A.; Henry, Christopher R.; M, Murad; Talukdar, Sumaiya; Satran, Daniel; Henry, Timothy D.

doi:10.1161/01.cir.0000165121.50527.de

Cited by 113 publications

(66 citation statements)

References 46 publications

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“…5–7 ACS was defined by the occurrence of either acute myocardial infarction (ST-Elevation Myocardial Infarction [STEMI] or Non-ST-Elevation Myocardial Infarction [NSTEMI]) or unstable angina pectoris (UAP) according to the AHA/ACC/ESC guidelines. 8 An expert panel consisting of one cardiologist and one ED physician reviewed all patient data forms including prospectively collected information on the chest pain history, demographics, cardiovascular risk factors, medical history, and results of coronary biomarkers, electrocardiograms, and other test performed during index hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Presence and Extent of Coronary Artery Disease by Cardiac Computed Tomography and Risk for Acute Coronary Syndrome in Cocaine Users Among Patients With Chest Pain

Bamberg

Schlett

Truong

et al. 2009

The American Journal of Cardiology

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Cocaine users represent an Emergency Department (ED) population that has been shown to be at increased risk for ACS; however, there is controversy about whether this higher risk is mediated through advanced atherosclerosis. Thus, we aimed to determine whether history of cocaine use is associated with acute coronary syndrome (ACS) and coronary artery disease using coronary computed tomography (CT). In this matched cohort study, we selected patients with a history of cocaine use and age- and gender-matched controls from a large cohort of consecutive patients who presented with acute chest pain to the ED. Coronary atherosclerotic plaque as detected by 64-slice coronary CT was compared between the groups. Among 412 patients, 44 had a history of cocaine use (9%) and were matched to 132 controls (mean age: 46±6 years, 86% male). History of cocaine use was associated with a 6-fold higher risk for ACS (odds ratio: 5.79, 95%-confidence interval: 1.24–27.02, p=0.02), but was not associated with a higher prevalence of any plaque, calcified plaque, or non-calcified plaque (p=1.0, p=1.0; and p=0.58, respectively) or the presence of significant stenosis (p=0.09). History of cocaine use was also not associated with the extent of any, calcified, or non-calcified plaque (p=0.67, p=0.30, and p=0.12, respectively). These associations persisted after adjustment for other cardiovascular risk factors. In conclusion, among ED patients presenting with acute chest pain, history of cocaine use is associated with an increase in risk for ACS; however, this was not attributable to a higher presence or extent of coronary atherosclerotic plaque.

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Section: Methodsmentioning

confidence: 99%

Presence and Extent of Coronary Artery Disease by Cardiac Computed Tomography and Risk for Acute Coronary Syndrome in Cocaine Users Among Patients With Chest Pain

Bamberg

Schlett

Truong

et al. 2009

The American Journal of Cardiology

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“…Use of drugs such as cocaine, protease inhibitors, amphetamines is additionally responsible for CAAs (22, 95). The potential mechanism of CAA formation among cocaine users may be from severe hypertension episodes and the direct endothelial damage caused by vasoconstriction (96). …”

Section: Pathogenesis and Etiologymentioning

confidence: 99%

Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment

Sherif

Tok

Taşköylü

et al. 2017

Front. Cardiovasc. Med.

213

189

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Coronary artery aneurysms (CAAs) are uncommon and describe a localized dilatation of a coronary artery segment more than 1.5-fold compared with adjacent normal segments. The incidence of CAAs varies from 0.3 to 5.3%. Ever since the dawn of the interventional era, CAAs have been increasingly diagnosed on coronary angiography. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. The natural history of CAAs remains unclear; however, several recent studies have postulated the underlying molecular mechanisms of CAAs, and genome-wide association studies have revealed several genetic predispositions to CAA. Controversies persist regarding the management of CAAs, and emerging findings support the importance of an early diagnosis in patients predisposed to CAAs, such as in children with KD. This review aims to summarize the present knowledge of CAAs and collate the recent advances regarding the epidemiology, etiology, pathophysiology, diagnosis, and treatment of this disease.

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“…In contrast to the typical patient with FMD, patients who use cocaine and have cardiac symptoms are most frequently male and smoke cigarettes (53–55). Urine toxicology screening may be diagnostic for cocaine ingestion (56).…”

Section: Differential Diagnosismentioning

confidence: 99%

Coronary Artery Manifestations of Fibromuscular Dysplasia

Michelis

Olin

Kadian-Dodov

et al. 2014

Journal of the American College of Cardiology

123

105

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Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic “string of beads” that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies.

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Increased Prevalence of Coronary Artery Aneurysms Among Cocaine Users

Cited by 113 publications

References 46 publications

Presence and Extent of Coronary Artery Disease by Cardiac Computed Tomography and Risk for Acute Coronary Syndrome in Cocaine Users Among Patients With Chest Pain

Presence and Extent of Coronary Artery Disease by Cardiac Computed Tomography and Risk for Acute Coronary Syndrome in Cocaine Users Among Patients With Chest Pain

Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment

Coronary Artery Manifestations of Fibromuscular Dysplasia

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