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(Circulation. 1999;100:1939.)
© 1999 American Heart Association, Inc.

Images in Cardiovascular Medicine

Tirofiban for Cocaine-Induced Coronary Artery Thrombosis

A Novel Therapeutic Approach

Nikolaos G. Frangogiannis, MD; John A. Farmer, MD; Nasser M. Lakkis, MD

From the Section of Cardiology, Department of Medicine, Baylor College of Medicine, and Ben Taub General Hospital, Houston, Tex.

Correspondence to Nasser M. Lakkis, MD, The Methodist Hospital, 6550 Fannin, SM 677, Houston TX 77030.

	Introduction

Top Introduction

 
A34-year-old man presented with crushing substernal chest pain associated with ingestion of crack cocaine. An ECG showed findings consistent with an acute anterior wall myocardial infarction complicated by intermittent complete heart block. A coronary angiogram demonstrated diffuse thrombosis of the left anterior descending (LAD) coronary artery (arrow) (Figure, panel A). A temporary pacemaker was placed, and the patient was treated with heparin and the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitor tirofiban 0.4 mg · kg^-1 · min^-1 bolus over 30 minutes followed by 0.1 µg · kg^-1 · min^-1 for 72 hours. Coronary angiography was repeated 7 days later, showing normal coronary arteries without residual thrombus or coronary stenosis (panel B). GP IIb/IIIa inhibitors may be useful as first-line therapy in cocaine-induced coronary thrombosis.

View larger version (104K): [in this window] [in a new window]   Figure 1.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Frangogiannis, N. G. Articles by Lakkis, N. M. Search for Related Content PubMed PubMed Citation Articles by Frangogiannis, N. G. Articles by Lakkis, N. M. Related Collections Cardiovascular Pharmacology Coronary imaging: angiography/ultrasound/Doppler/CC Acute myocardial infarction