PMID- 24388623
OWN - NLM
STAT- MEDLINE
DCOM- 20140421
LR  - 20220408
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 113
IP  - 5
DP  - 2014 Mar 1
TI  - Characteristics, management, and outcomes of cocaine-positive patients with acute 
      coronary syndrome (from the National Cardiovascular Data Registry).
PG  - 749-56
LID - S0002-9149(13)02368-0 [pii]
LID - 10.1016/j.amjcard.2013.11.023 [doi]
AB  - 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 beta-blocker usage. Cocaine use was not associated with 
      in-hospital mortality.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Gupta, Navdeep
AU  - Gupta N
AD  - Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. 
      Electronic address: dr_navdeep@yahoo.com.
FAU - Washam, Jeffrey B
AU  - Washam JB
AD  - Duke Heart Center, Duke University Medical Center, Durham, North Carolina.
FAU - Mountantonakis, Stavros E
AU  - Mountantonakis SE
AD  - Department of Medicine, Section of Cardiac Electrophysiology, North Shore 
      University Hospital, Manhasset, New York.
FAU - Li, Shuang
AU  - Li S
AD  - Duke Clinical Research Institute, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Roe, Matthew T
AU  - Roe MT
AD  - Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - de Lemos, James A
AU  - de Lemos JA
AD  - Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Arora, Rohit
AU  - Arora R
AD  - Department of Medicine, Chicago Medical School, Rosalind Franklin University of 
      Medicine and Science, North Chicago, Illinois.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131212
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Adrenergic beta-Antagonists)
RN  - I5Y540LHVR (Cocaine)
SB  - IM
MH  - Acute Coronary Syndrome/*chemically induced/therapy
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Adult
MH  - Cocaine/adverse effects
MH  - Cocaine-Related Disorders/*complications
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*chemically induced/epidemiology/therapy
MH  - Percutaneous Coronary Intervention/statistics & numerical data
MH  - Registries
MH  - Risk Factors
MH  - Shock, Cardiogenic/epidemiology
MH  - Stents/statistics & numerical data
MH  - United States/epidemiology
EDAT- 2014/01/07 06:00
MHDA- 2014/04/22 06:00
CRDT- 2014/01/07 06:00
PHST- 2013/07/15 00:00 [received]
PHST- 2013/11/07 00:00 [revised]
PHST- 2013/11/07 00:00 [accepted]
PHST- 2014/01/07 06:00 [entrez]
PHST- 2014/01/07 06:00 [pubmed]
PHST- 2014/04/22 06:00 [medline]
AID - S0002-9149(13)02368-0 [pii]
AID - 10.1016/j.amjcard.2013.11.023 [doi]
PST - ppublish
SO  - Am J Cardiol. 2014 Mar 1;113(5):749-56. doi: 10.1016/j.amjcard.2013.11.023. Epub 
      2013 Dec 12.