Aaron D. Kugelmass, MD; J. Anthony Ware, MD
To the Editors: We, like Minor and colleagues (1), have noted the apparently high incidence of thrombotic occlusion of coronary arteries lacking angiographically demonstrable lesions among the reported cases of cocaine-induced myocardial infarction. Cocaine might activate platelets or enhance activation by physiologic mediators, even though most local anesthetics inhibit platelet activation. In support of this theory, Minor and coworkers (1) cited in-vitro studies conducted by Togna and colleagues (2), in which low concentrations of cocaine reduced the threshold at which exogenous arachidonic acid induced platelet aggregation and thromboxane B2 synthesis. These studies were performed in platelet-rich rabbit plasma, but platelet
Aaron D. Kugelmass, J. Anthony Ware. Cocaine and Coronary Artery Thrombosis. Ann Intern Med. 1992;116:776–777. doi: 10.7326/0003-4819-116-9-776_2
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Published: Ann Intern Med. 1992;116(9):776-777.
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