Percutaneous interventions in patients with cocaine-associated myocardial infarction: a case series and review.
Cocaine-associated myocardial infarction (CAMI) is a well-reported entity. Most previous reports on CAMI have been limited to conservative care utilizing benzodiazepines, aspirin, nitroglycerin, calcium channel blockers, and thrombolytics. Current guidelines on CAMI advocate immediate use of angiography and angioplasty if available rather than routine administration of thrombolytics. However, based on literature search from 1966 to 2001 (using keywords "cocaine," "myocardial infarction," and "angioplasty"), there have been only two case reports of percutaneous coronary intervention (PCI) in patients with cocaine-associated myocardial infarction. Both were notable for complications either during or immediately after the procedure. We report a series of 10 patients with cocaine-associated myocardial infarction who were treated with percutaneous interventions, which included angioplasty, stenting, and AngioJet mechanical extraction of thrombus. Despite the different arteriopathic process involved, our findings suggest that PCI can be performed safely and with a high degree of procedural success in patients with CAMI.
Section of Cardiology, Washington Hospital Center, Washington, DC 20010, USA. arvshar@aol.com
Arvind K
AK
Sharma
Shadi M
SM
Hamwi
Nidhi
N
Garg
Marco T
MT
Castagna
William
W
Suddath
Samer
S
Ellahham
Joseph
J
Lindsay
D015906:Angioplasty, Balloon, Coronary; D019970:Cocaine-Related Disorders / Q000150:complications*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000628:therapy; D003329:Coronary Vasospasm / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D018084:Ultrasonography, Interventional