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

125 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
Pages (from-to)492-496
Number of pages5
JournalAmerican Journal of Medicine
Issue number6
StatePublished - Jun 1994

ASJC Scopus subject areas

  • General Medicine


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