Aneurysms frequent in cocaine users.

Cocaine abuse sends more people to hospital emergency rooms than any other illegal drug because it can cause high blood pressure, heart attacks, strokes, and the chest pain called angina. Now, a study in Minnesota of cocaine users examined for angina or other heart problems finds that these drug users are unusually susceptible to coronary aneurysms, a rare condition in which a weak spot balloons out from the coronary arteries, the blood vessels that nourish the heart. The cocaine users were six times as likely to have a coronary aneurysm as are other people with known heart disease, the highest-risk group previously identified.

Coronary aneurysms aren't as dangerous as brain aneurysms and typically aren't treated since they rarely burst. However, a coronary aneurysm places a patient at increased risk of heart attack. The swirling, disrupted blood flow at an aneurysm promotes atherosclerosis, the formation of hard, fatty plaques in the vessels, says cardiologist Timothy D. Henry of Hennepin County Medical Center (HCMC) in Minneapolis, an investigator in the cocaine study.

Of 112 cocaine users participating in the study, 34 had coronary aneurysms, reports physician Aaron Satran of HCMC. Satran notes that nearly all the participants smoked and that three-fourths had high blood pressure and high cholesterol readings--factors that could boost their risk of aneurysm.

Still, the incidence of coronary aneurysms was sharply higher than the 5 percent rate that other researchers found in a previous study of 20,087 heart patients, who had similar risk factors. In both investigations, physicians detected aneurysms by using angiography, an X-ray technique in which dye is injected into the arteries.

In the latest study, the participants classified as moderate or severe cocaine users by Satran and Henry were more than twice as likely to have a coronary aneurysm as mild users were.

The researchers didn't determine whether the cocaine users, whose average age was 44, have aneurysms elsewhere in the body. Moreover, the scientists haven't yet looked into the mechanism underlying the coronary aneurysms. "If cocaine does in fact cause aneurysms, we're still unsure as to how it does," Satran says.