Cocaine-induced coronary thrombosis: what is the optimal treatment strategy

Rusovici, Arthur; Varkey, Santosh; Saeed, Qaisra; Klapholz, Marc; Haider, Bunyad; Kaluski, Edo

doi:10.1016/j.carrev.2010.06.004

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Cocaine also enhances plasminogen activator inhibitor activities (PAI‐I) . Enhanced platelet activities and PAI‐I lead to a transient hypercoagulopathy state with potential for life‐threatening coronary arterial thrombosis and spontaneous embolization . Furthermore, concurrent cigarette smoking with the use of cocaine can potentiate the prothrombic events .…”

Section: Discussionmentioning

confidence: 99%

Acute renal infarction, transient ischemic attack, and biventricular thrombi secondary to substance use disorder: A case report

Ghassemi

Bharadia

Liu

2019

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Acute renal infarction, transient ischemic attack, and biventricular thrombi secondary to substance use disorder: A case report

Ghassemi

Bharadia

Liu

2019

Clinical Case Reports

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“…Regarding pathophysiology, cardiovascular complications associated with cocaine such as arrhythmia, AMI and sudden death are usually linked to excess catecholamine, which results in increased sympathetic activity, mediated by the neurotransmitter noradrenaline, which acts by increasing the metabolic demand for oxygen through tachycardia, the elevation of blood pressure and hyperdynamic left ventricle. The drug presents strong arterial vasoconstrictor action by stimulating adrenergic receptors, increased production of endothelin-1 (a potent vasoconstrictor) and decreased nitric oxide 10,12,28,29,30,31 .…”

Section: Pathophysiology Of Cardiovascular Repercussions Caused By Cocainementioning

confidence: 99%

Repercussões cardiovasculares em usuários de cocaína: uma revisão integrativa

Pantaleão¹,

Lins²,

Filho³

2021

Medicina (Ribeirão Preto)

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Introdução: O uso da cocaína é considerado um importante problema de saúde, sendo crescente o número de atendimentos nos serviços de emergência de pacientes que referem sintomas relacionados a alterações cardiovasculares após seu uso. Objetivo: Apresentar as repercussões cardiovasculares promovidas pela cocaína, associando o seu consumo a possíveis desfechos fatais, além de discutir as melhores maneiras de abordar o paciente na emergência. Método: Revisão integrativa da literatura nas bases de dados eletrônicas LILACS, MEDLINE, IBECS, SciELO, Secretaria Municipal de Saúde de São Paulo, Secretaria Estadual de Saúde de São Paulo, Coleciona SUS, disponíveis na BVS, bem como no PubMed. Resultados: Após análise criteriosa, 44 artigos atenderam aos critérios de inclusão. Foram estudos realizados na Europa (25%), Austrália (6,82%) e no continente americano (68,18%). Discussão: Abuso de cocaína é considerado um fator de risco isolado para doenças cardiovasculares, independente de outros. Por isso, pacientes jovens admitidos com dor torácica devem ser questionados sobre o consumo dessa droga. O tratamento do IAM associado ao uso de cocaína é semelhante ao realizado em paciente não usuário e, apesar da controvérsia existente sobre existir ou não contraindicação ao emprego de betabloqueador, diversos estudos indicam a utilização de drogas alfa e beta bloqueadores nesses pacientes. Conclusão: constatou-se que as principais repercussões cardiovasculares encontradas em pacientes usuários de cocaína que procuraram atendimento nas emergências hospitalares foram as emergências/urgências hipertensivas, taquicardia supraventricular, angina, infarto agudo do miocárdio, dissecção e aneurisma de aorta.

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“…Some of these patients may have premature atherosclerosis, illegal drug abuse (e.g. cocaine), 18,19 a strong family/genetic predisposition to MI, 20,21 or spontaneous coronary artery dissection. 22 In women under 50 years of age, smoking was observed in eight out of 10 patients with STEMI.…”

Section: The Association Between Age and Smoking In Patients With Stemimentioning

confidence: 99%

“…Age, years 59 (17) 68 (16) 67 (18) 63 (18) <0.001 Men 735958 (16) 67 (16) 64 (17) 62 (17) <0.001 Women 255561 (19) 71 (16) 75 (17) 67 (20 came from one of the three coronary intervention centres included in the Western Denmark Heart Registry. Sensitivity analyses, excluding this specific centre, showed no changes in estimates and therefore the limitation caused by this must be limited.…”

Section: Current Smoking N=5000mentioning

confidence: 99%

Smoking is the dominating modifiable risk factor in younger patients with STEMI

Gleerup

Dahm

Thim

et al. 2018

European Heart Journal: Acute Cardiovascular Care

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Aims: Smoking is an important modifiable risk factor for myocardial infarction. It is unclear whether smoking habits at the time of an incident ST-segment elevation myocardial infarction (STEMI) differ across age groups and sex. Methods and results: We included patients with incident STEMI registered in the Western Denmark Heart Registry from 2005 to 2015 ( n=9914). Patients were divided into four age groups (30–49, 50–59, 60–69 and ⩾70 years) with the latter serving as reference. Smoking was the most prevalent modifiable risk factor in 30–49-year-old patients (74% vs. hypertension 15%, hyperlipidaemia 10% and diabetes 7%). The smoking prevalence decreased with increasing age, while treatment for hypertension, hyperlipidaemia and diabetes increased with increasing age. Smoking was five times (odds ratio (OR) 5.15; 95% confidence interval (CI) 4.37–6.07) more prevalent among 30–49-year-old patients with STEMI than the reference group. Differences according to sex were significant as the OR for current smoking in women was 9.88 (95% CI 6.94–14.08) compared to OR 3.78 (95% CI 3.12–4.58) in men. Conclusions: Despite public information campaigns and general warnings, smoking remains the most prevalent modifiable risk factor in younger patients with STEMI.

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Cocaine-induced coronary thrombosis: what is the optimal treatment strategy

Cited by 4 publications

References 24 publications

Acute renal infarction, transient ischemic attack, and biventricular thrombi secondary to substance use disorder: A case report

Acute renal infarction, transient ischemic attack, and biventricular thrombi secondary to substance use disorder: A case report

Repercussões cardiovasculares em usuários de cocaína: uma revisão integrativa

Smoking is the dominating modifiable risk factor in younger patients with STEMI

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