title: Relationship between coronary artery ectasia, cocaine abuse and acute coronary syndromes.
abstract: Coronary artery ectasia (CAE) often represents a coronary angiography finding casually detected or following the occurrence of an acute coronary syndrome. The pathogenetic role of cocaine abuse in the genesis of CAE is still little known and very few data are available in literature. We describe a case of a 31-year-old male cocaine user admitted to our department for typical acute chest pain. Coronary angiography showed diffuse coronary ectasia with slow flows and without hemodynamically significant stenosis. An increasing of matrix metalloproteinases values and a reduction of their tissue inhibitors was showed both during hospitalization and at one month after discharge. This case report emphasizes the close relationship between cocaine abuse, CAE and acute coronary syndromes in patients without hemodynamically significant coronary stenosis. As reported by Satran et al, cocaine abuse should be considered an important risk factor for CAE and these patients appear to be at increased risk of angina and acute myocardial infarct. Further studies that can strengthen this hypothesis would be useful to deepen and better analyze this interesting association.
authors.affiliation: Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato, Division of Cardiology, Department of Internal Medicine and Cardiovascular Diseases, Section of Intensive Coronary Care Unit, University Hospital "Paolo Giaccone", 90127 Palermo, Italy.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dendramis
authors.affiliation: Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato, Division of Cardiology, Department of Internal Medicine and Cardiovascular Diseases, Section of Intensive Coronary Care Unit, University Hospital "Paolo Giaccone", 90127 Palermo, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Paleologo
authors.affiliation: Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato, Division of Cardiology, Department of Internal Medicine and Cardiovascular Diseases, Section of Intensive Coronary Care Unit, University Hospital "Paolo Giaccone", 90127 Palermo, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Piraino
authors.affiliation: Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato, Division of Cardiology, Department of Internal Medicine and Cardiovascular Diseases, Section of Intensive Coronary Care Unit, University Hospital "Paolo Giaccone", 90127 Palermo, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Assennato
keywords: Acute coronary syndromes; Cocaine abuse; Coronary artery ectasia; Inflammation; Matrix metalloproteinases