Influence of intranasal cocaine on plasma constituents associated with endogenous thrombosis and thrombolysis

David J. Moliterno, Richard A Lange, Robert D. Gerard, John E. Willard, Carolin Lackner, L. David Hillis

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


purpose: As cocaine abuse has become widespread, catastrophic cocaine-associated cardiovascular events have been noted with increasing frequency. Although these incidents are thought to be caused by drug-induced vasoconstriction and/or arterial thrombosis, the influence of cocaine on the plasma constituents involved in endogenous thrombosis and thrombolysis has not been characterized. patients and methods: In 22 patients (8 men, 14 women, ages 32 to 62 years) undergoing cardiac catheterization, blood samples were procured before and 15 minutes after the administration of intranasal saline (n = 8, controls) or cocaine, 2 mg/kg (n = 14), and the plasma concentrations of fibrinogen, plasminogen, and lipoprotein(a), as well as tissue plasminogen activator activity and plasminogen activator inhibitor (PAI-1) activity, were measured. results: No variable changed with the use of intranasal saline, whereas the use of cocaine resulted in an increase in PAI-1 activity (0.48 + 0.06 [mean + SD] nmol/L at baseline, 0.53 + 0.05 nmol/L after cocaine, P = 0.011). conclusion: Intranasal cocaine administration is associated with an increase in plasma PAI-1 activity. This may be important in recreational users of cocaine who experience vascular thrombosis.

Original languageEnglish (US)
Pages (from-to)492-496
Number of pages5
JournalThe American Journal of Medicine
Issue number6
StatePublished - Jun 1994
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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