Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2016; 8(5): 351-355
Published online May 26, 2016. doi: 10.4330/wjc.v8.i5.351
Relationship between coronary artery ectasia, cocaine abuse and acute coronary syndromes
Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato
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
Author contributions: Dendramis G designed the report, analyzed the data and wrote the paper; Paleologo C collected the patient’s clinical data; Piraino D and Assennato P analyzed the data.
Institutional review board statement: Interventional Cardiology, “P.Giaccone” University Hospital of Palermo Institutional Review Board.
Informed consent statement: All involved persons gave their informed prior to study inclusion.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gregory Dendramis, MD, Division of Cardiology, Department of Internal Medicine and Cardiovascular Diseases, Section of Intensive Coronary Care Unit, University Hospital “Paolo Giaccone”, Via del Vespro, 127, 90127 Palermo, Italy. gregorydendramis@libero.it
Telephone: +39-091-6554303 Fax: +39-091-6554303
Received: January 2, 2016
Peer-review started: January 3, 2016
First decision: February 2, 2016
Revised: February 16, 2016
Accepted: March 7, 2016
Article in press: March 9, 2016
Published online: May 26, 2016
Processing time: 139 Days and 5.5 Hours
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.

Keywords: Coronary artery ectasia; Acute coronary syndromes; Cocaine abuse; Matrix metalloproteinases; Inflammation

Core tip: The pathogenetic role of cocaine abuse in the genesis of coronary artery ectasia (CAE) is still little known and very few data are available in literature. 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 appears to be another potential mechanism of acute coronary syndromes in cocaine users. Further studies that can strengthen this hypothesis would be useful to deepen and better analyze this interesting association.