Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: Enhanced vasoconstriction at sites of significant stenoses

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...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1990-07, Vol.16 (1), p.74-79
Main Authors: Flores, Eduardo D., Lange, Richard A., Cigarroa, Ricardo G., Hillis, L.David
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Cocaine - pharmacology
Coronary Artery Disease - pathology
Coronary Artery Disease - physiopathology
Coronary heart disease
Coronary Vessels - drug effects
Female
Heart
Hemodynamics - drug effects
Humans
Male
Medical sciences
Middle Aged
Vasoconstriction - drug effects
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Summary: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 < 0.05). Thus, cocaine causes vasoconstriction of diseased and nondiseased coronary artery segments, but its effect is particularly marked in the former.
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(90)90459-3