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Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry).

Publication ,  Journal Article
Gupta, N; Washam, JB; Mountantonakis, SE; Li, S; Roe, MT; de Lemos, JA; Arora, R
Published in: Am J Cardiol
March 1, 2014

Although cocaine ingestion may cause or contribute to myocardial infarction (MI), few contemporary data are available describing cocaine-associated MI. We describe the characteristics, management, and outcomes of patients with MI and recent cocaine use from the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) program. The study population was 102,952 patients enrolled in the American College of Cardiology ACTION Registry-GWTG from July 2008 to March 31, 2010 from 460 sites across the United States. Cocaine exposure was defined as self-reported cocaine use within the last 72 hours or a positive urine test for cocaine. Demographics and medical history, presenting characteristics, treatments, and in-hospital outcomes were reported on a standard case record form. A total of 924 patients (0.9%) were cocaine positive. Compared with cocaine-negative patients, cocaine-positive patients were younger and predominantly men with fewer cardiovascular risk factors. There was a higher percentage of ST elevation myocardial infarction (STEMI) (46.3% vs 39.7%) and cardiogenic shock at presentation in the cocaine-positive group, but the percentage of multivessel coronary artery disease was lower (53.3% vs 64.5%). Beta blockers within 24 hours (85.8% vs 90.1%, p <0.0001) and drug-eluting stents (40.1% vs 68.8%, p <0.0001 in patients with non-STEMI; 27.6% vs 54.6%, p <0.0001 in patients with STEMI) were used less commonly in cocaine-positive patients. Multivariable-adjusted in-hospital mortality was similar between cocaine-positive and cocaine-negative patients (adjusted odds ratio 1.00, 95% confidence interval 0.69 to 1.44, p value = 0.98). In conclusion cocaine-positive patients with acute coronary syndrome are younger with fewer risk factors, multivessel coronary artery disease and lower drug-eluting stent and β-blocker usage. Cocaine use was not associated with in-hospital mortality.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

March 1, 2014

Volume

113

Issue

5

Start / End Page

749 / 756

Location

United States

Related Subject Headings

  • United States
  • Stents
  • Shock, Cardiogenic
  • Risk Factors
  • Registries
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gupta, N., Washam, J. B., Mountantonakis, S. E., Li, S., Roe, M. T., de Lemos, J. A., & Arora, R. (2014). Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry). Am J Cardiol, 113(5), 749–756. https://doi.org/10.1016/j.amjcard.2013.11.023
Gupta, Navdeep, Jeffrey B. Washam, Stavros E. Mountantonakis, Shuang Li, Matthew T. Roe, James A. de Lemos, and Rohit Arora. “Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry).Am J Cardiol 113, no. 5 (March 1, 2014): 749–56. https://doi.org/10.1016/j.amjcard.2013.11.023.
Gupta N, Washam JB, Mountantonakis SE, Li S, Roe MT, de Lemos JA, et al. Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry). Am J Cardiol. 2014 Mar 1;113(5):749–56.
Gupta, Navdeep, et al. “Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry).Am J Cardiol, vol. 113, no. 5, Mar. 2014, pp. 749–56. Pubmed, doi:10.1016/j.amjcard.2013.11.023.
Gupta N, Washam JB, Mountantonakis SE, Li S, Roe MT, de Lemos JA, Arora R. Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry). Am J Cardiol. 2014 Mar 1;113(5):749–756.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

March 1, 2014

Volume

113

Issue

5

Start / End Page

749 / 756

Location

United States

Related Subject Headings

  • United States
  • Stents
  • Shock, Cardiogenic
  • Risk Factors
  • Registries
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans