Spectrum of electrocardiographic and angiographic coronary artery disease findings in patients with cocaine-associated myocardial infarction

Mohamad, Tamam; Niraj, Ashutosh; Farah, Jareer; Obideen, Mahmoud; Badheka, Apurva; Kondur, Ashok; Thatai, Deepak; Afonso, Luís

doi:10.1097/mca.0b013e32832b906c

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…There have been multiple reports of cocaine-induced myocardial infarctions (MI) in patients abusing it [ 16 - 18 ]. It was evident in our study that the prevalence of acute MI increased steadily over the past decade, 4.13 in 2006 to 7.85 in 2018 (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Gangu¹,

Bobba²,

Basida³

et al. 2022

Cureus

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Objective About 41 million people aged ≥18 years reported lifetime use of cocaine, and 5.4 million people reported having used cocaine in 2019. We aim to identify trends of cocaine use, manifestations, concomitant drug use, and financial burden on health care among hospitalized patients. Methods We utilized National Inpatient Sample from years 2006-2018. Patients with age ≥18 years, admitted to the hospital with a diagnosis of cocaine abuse, dependence, poisoning, or unspecified cocaine use were included in the study. We used ICD-9 Clinical Modification (CM) and ICD-10-CM codes to retrieve patient samples and comorbid conditions. The primary outcome was the trend in cocaine use among hospitalized patients from the year 2006 to 2018. Cochran-Mantel-Haenszel test was used to assess the significance of trends. Results In the year 2006, the prevalence of cocaine abuse among hospitalized patients was 10,751 per million with an initial decline to 7,451 per million in 2012 and a subsequent increase to 11,891 per million hospitalized patients in 2018 with p =0.01. The majority of patients admitted were older than 50 years (43.27%), and a greater percentage of patients were males. All ethnicities showed a rising trend in the use of cocaine except for Native Americans. Cardiovascular effects, neuropsychiatric and infectious manifestations in hospitalized patients with cocaine abuse showed a consistent increase from year 2006 to 2018 with p <0.001. Conclusions There is a recent uptrend in cocaine use among hospital admissions in the US from 2006 to 2018 with an increased rate of systemic manifestations. This highlights the impact of cocaine use on the health system and the dire need to address this growing problem.

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Section: Discussionmentioning

confidence: 99%

Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Gangu¹,

Bobba²,

Basida³

et al. 2022

Cureus

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“…Although they have been described in many case reports [3], they are probably still underreported. Reports of iatrogenic cardiac complications on the other hand, are more rare.…”

Section: Discussionmentioning

confidence: 99%

Coronary spasm after the topical use of cocaine in nasal surgery

et al. 2013

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SummaryBackground:Cocaine is a frequently used recreational drug which imposes important health problems with even life-threatening cardiotoxicity. The therapeutic use of cocaine is nowadays restricted to topical anesthesia in ophthalmological and nasal surgery but the possible hazards of this local anesthesia are not always fully appreciated.Case Report:A 51-year old male patient with moderate cardiovascular risk profile underwent elective nasal surgery and cocaine was used as a local anesthetic. During surgery, ventricular arrhythmias and cardiogenic shock occurred, mimicking an ST-segment elevation myocardial infarction (STEMI) in sinus rhythm. Coronary angiography showed diffuse spasm of the right coronary artery (RCA) which disappeared with intracoronary nitrates. Urine analysis was positive for cocaine. The patient recovered completely with a normal echocardiography and ECG at discharge.Conclusions:Cocaine cardiotoxicity is not uncommon in the community but a particular situation arises when used in medicine as a topical anesthetic. This is the first case report, to our knowledge, of a cardiogenic shock mimicking a STEMI with documentation of diffuse coronary spasm after cocaine use in nasal surgery. One must be aware of the potential life-threatening complications in this low-risk surgery, moreover when safer alternatives are available.

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“…The angiography in patients with myocardial infarction reveals one-vessel or two-vessel disease in 31-66% of cases, tree-vessel disease in 13-15% of cases, normal coronary arteries in 18-45% and thrombus without obstructive disease in 24% of cases [8,12,13].…”

Section: Chest Painmentioning

confidence: 99%

Illicit drugs and their impact on cardiovascular pathology

Bădilă

Hostiuc

Weiss

et al. 2015

Romanian Journal of Internal Medicine

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The use of illicit drugs has dramatically increased during the past years. Consequently, the number of presentations at the emergency departments due to the adverse effects of the illicit drugs has also increased. This review discusses the cardiovascular effects of cocaine, opiates and opioids, cannabinoids, amphetamines, methamphetamines and hallucinogens as we consider that it is essential for a clinician to be aware of them and understand their mechanisms in order to optimize the therapeutic management.

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Spectrum of electrocardiographic and angiographic coronary artery disease findings in patients with cocaine-associated myocardial infarction

Abstract: The majority of patients with cocaine-associated MI have obstructive CAD with predominant single-vessel disease. Although ECG abnormalities are frequently encountered, they are of limited diagnostic value in the clinical decision making.

Cited by 11 publications

References 18 publications

Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Coronary spasm after the topical use of cocaine in nasal surgery

Illicit drugs and their impact on cardiovascular pathology

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