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

Am J Med. 1994 Jun;96(6):492-6. doi: 10.1016/0002-9343(94)90087-6.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Intranasal
  • Adult
  • Blood Coagulation / drug effects*
  • Blood Coagulation Factors / metabolism*
  • Chi-Square Distribution
  • Cocaine / administration & dosage
  • Cocaine / pharmacology*
  • Female
  • Fibrinogen / metabolism
  • Humans
  • Lipoprotein(a) / blood
  • Male
  • Middle Aged
  • Plasminogen / metabolism
  • Plasminogen Activator Inhibitor 1 / blood
  • Tissue Plasminogen Activator / blood


  • Blood Coagulation Factors
  • Lipoprotein(a)
  • Plasminogen Activator Inhibitor 1
  • Fibrinogen
  • Plasminogen
  • Tissue Plasminogen Activator
  • Cocaine