The Cardiovascular Effects of Cocaine

Havakuk, Ofer; Rezkalla, Shereif H.; Kloner, Robert A.

doi:10.1016/j.jacc.2017.05.014

Cited by 174 publications

(130 citation statements)

References 128 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…Long-term abuse of cocaine is also known to cause DCM and lethal arrhythmias 115 . Depressed LV function has been reported in 4-9% of individuals who used cocaine and had cardiac symptoms 116,117 .…”

Section: Chemical and Toxin Exposurementioning

confidence: 99%

Dilated cardiomyopathy

Schultheiss

Fairweather

Caforio

et al. 2019

Nat Rev Dis Primers

394

381

View full text Add to dashboard Cite

www.nature.com/nrdp P r i m e r 0123456789(); P r i m e r 0123456789(); 4 | Article citation ID: (2019) 5:32 www.nature.com/nrdp P r i m e r 0123456789(); P r i m e r 0123456789(); P r i m e r 0123456789(); 7 NATURE REVIEwS | DIsEAsE PRIMERs | Article citation ID: (2019) 5:32 P r i m e r 0123456789(); P r i m e r 0123456789(); 9 NATURE REVIEwS | DIsEAsE PRIMERs | Article citation ID: (2019) 5:32 P r i m e r 0123456789(); P r i m e r 0123456789(); P r i m e r 0123456789(); (2019) 5:32 www.nature.com/nrdp P r i m e r 0123456789(); P r i m e r 0123456789();

show abstract

Section: Chemical and Toxin Exposurementioning

confidence: 99%

Dilated cardiomyopathy

Schultheiss

Fairweather

Caforio

et al. 2019

Nat Rev Dis Primers

394

381

View full text Add to dashboard Cite

show abstract

“…In a complementary study, Thiara and colleagues found an increased extent of diffuse myocardial fibrosis among PHIV 23. In addition, our cohort had HF, CAD, and increased rates of cocaine use, all of which are also associated with an increase in both the presence and extent of myocardial fibrosis 24, 25. For example, late gadolinium enhancement has been reported in >30% of patients with a nonischemic cardiomyopathy and >80% of patients with an ischemic cardiomyopathy 25.…”

Section: Discussionmentioning

confidence: 50%

“…This increased rate of hospitalization was also noted to occur in association with an increased rate of cocaine use. Cocaine use is additionally important herein, as detailed previously, because it also increases the defibrillation threshold,24, 37 leading to a reduced likelihood of response to a standard ICD discharge and an increase in mortality.…”

Section: Discussionmentioning

confidence: 88%

“…For example, late gadolinium enhancement has been reported in >30% of patients with a nonischemic cardiomyopathy and >80% of patients with an ischemic cardiomyopathy 25. Cocaine use leads to heightened sympathetic tone,26 blocks sodium channels,26 and can lead to myocardial fibrosis 24. The use of cocaine may also affect the prescription of standard HF medications, which reduce the burden of ventricular arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV

Alvi

Neilan

Tariq

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundPeople living with HIV (PHIV) are at an increased risk for sudden cardiac death, and implantable cardioverter‐defibrillators (ICDs) prevent SCD. There are no data on the incidence, predictors, and effects of ICD therapies among PHIV.Methods and ResultsWe compared ICD discharge rates between 59 PHIV and 267 uninfected controls. For PHIV, we tested the association of traditional cardiovascular risk factors and HIV‐specific parameters with an ICD discharge and then tested whether an ICD discharge among PHIV was associated with cardiovascular mortality or an admission for heart failure. The indication for ICD insertion was similar among groups. Compared with controls, PHIV with an ICD were more likely to have coronary artery disease and to use cocaine. In follow‐up, PHIV had a higher ICD discharge rate (39% versus 20%; P=0.001; median follow‐up period, 19 months). Among PHIV, cocaine use, coronary artery disease, QRS duration, and higher New York Heart Association class were associated with an ICD discharge. An ICD discharge had a prognostic effect, with a subsequent 1.7‐fold increase in heart failure admission and a 2‐fold increase in cardiovascular mortality, an effect consistent across racial/ethnic and sex categories.Conclusions ICD discharge rates are higher among PHIV compared with uninfected controls. Among PHIV, cocaine use and New York Heart Association class are associated with increased ICD discharge, and an ICD discharge is associated with a subsequent increase in admission for heart failure and cardiovascular mortality.

show abstract

“…The management of cocaine-induced cardiotoxicity includes cardiovascular supportive care and monitoring [6]. Reports of cocaine-induced cardiac dysfunction are rare in paediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Cocaine‐induced cardiomyopathy in a paediatric patient

2018

View full text Add to dashboard Cite

Summary A 23‐month‐old healthy female presented for irrigation of obstructed nasolacrimal ducts under general anaesthesia. Induction of anaesthesia was uneventful and a supraglottic airway device was inserted. During the surgical procedure, gauze pledgets soaked in a solution containing 4% cocaine and 1:1000 adrenaline were inserted into both nostrils. The nasolacrimal ducts were irrigated with the same solution. The procedure lasted approximately twenty minutes and the pledgets were removed at the end. No adverse intraoperative events were noted. In the recovery room, the patient became agitated and developed signs of respiratory distress. Bilateral infiltrates consistent with pulmonary oedema were evident on the chest radiograph and a bedside echocardiogram demonstrated significantly impaired left ventricular function. Lateral T‐wave inversion was seen on the electrocardiogram and cardiac troponin levels were elevated. Following the exclusion of other causes of myocardial dysfunction, ischaemic cardiomyopathy due to cocaine‐induced vasospasm was considered to be the most likely diagnosis. This case highlights the hazards associated with the systemic absorption of cocaine, particularly when used in combination with adrenaline. Safe dosing regimens were not adhered to in this case and the dose of cocaine in the irrigation solution was not calculated. We suggest that cocaine should only be used in clinical practice when no safer alternative is available.

show abstract

The Cardiovascular Effects of Cocaine

Cited by 174 publications

References 128 publications

Dilated cardiomyopathy

Dilated cardiomyopathy

Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV

Cocaine‐induced cardiomyopathy in a paediatric patient

Contact Info

Product

Resources

About