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Cocaine and coronary artery diseases: a systematic review of the literature

Talarico, Giovanni P.; Crosta, Maria L.; Giannico, Maria B.; Summaria, Francesco; Calò, Leonardo; Patrizi, Roberto

Journal of Cardiovascular Medicine: May 2017 - Volume 18 - Issue 5 - p 291–294
doi: 10.2459/JCM.0000000000000511

Cocaine is associated with important cardiac complications such as sudden death, acute myocarditis, dilated cardiomyopathy, life-threatening arrhythmias, and myocardial ischemia as well as infarction. It is well known that cocaine may induce vasospasm through adrenergic stimulation of the coronary arteries. Moreover, cocaine may promote intracoronary thrombosis, triggered by alterations in the plasma constituents, and platelet aggregation, leading to subsequent myocardial infarction. The long-term use of cocaine may stimulate atherosclerosis, probably through endothelial cell dysfunction. Significant and severe coronary atherosclerosis is common in young chronic cocaine users and there is probably a relationship between the duration and frequency of cocaine use and the extent of coronary disease.

aDepartment of Cardiology, Policlinico Casilino

bDepartment of Psychiatry, Policlinico Agostino Gemelli, Rome, Italy

Correspondence to Giovanni P. Talarico, MD, Department of Cardiology, Policlinico Casilino, via Casilina 1049, 00169 Rome, Italy Tel: +39 0623188471; fax: +39 0623188408; e-mail:

Received 2 October, 2016

Revised 25 November, 2016

Accepted 14 January, 2017

© 2017 Italian Federation of Cardiology. All rights reserved.