Heavy cocaine users may put themselves at increased risk of developing a coronary artery aneurysm, a bulge at a weak point in the artery wall. This might contribute to the higher rate of Heart attacks seen among cocaine users, according to a report in the American Heart Association’s journal Circulation.

Dr. Timothy D. Henry at the University of Minnesota in Minneapolis and his associates compared x-ray images of the coronary arteries of 112 patients with a history of cocaine use and of 79 others who did not use cocaine.

Thirty percent of patients in the cocaine group had coronary artery aneurysms, versus 8 percent of controls.

“Because aneurysms have altered flow characteristics, we believe that predisposes to blood clots forming there,” Henry said in an interview. These clots could cut off blood supply to the heart muscle and thereby cause a Heart attack .

“We know that patients who use cocaine get heart attacks,” he continued, which is related to constriction of the blood vessels, increases in heart rate and blood pressure, and the increased ability of platelets to clump together.

“However, all those things are temporally related to the use of cocaine,” he noted. “The difference with this study is that aneurysms may be a reflection of heavy cocaine use that occurred 10 years ago.”

For that reason, Henry suggests that doctors should ask patients who develop a coronary artery aneurysm at an early age about their history of cocaine use.

As for how people with aneurysms should be treated, he recommended “treating cholesterol aggressively and keeping patients on more aggressive antiplatelet therapy,” such as aspirin and Plavix.

SOURCE: Circulation, May 17, 2005.