PMID- 28421838
OWN - NLM
STAT- MEDLINE
DCOM- 20170425
LR  - 20170425
IS  - 1556-9519 (Electronic)
IS  - 1556-3650 (Linking)
VI  - 55
IP  - 5
DP  - 2017 Jun
TI  - Self-reported cocaine use is not associated with elevations in high-sensitivity 
      troponin I.
PG  - 332-337
LID - 10.1080/15563650.2017.1285404 [doi]
AB  - OBJECTIVE: High-sensitivity troponin (hsTn) assays detect 10 times lower 
      concentrations of cardiac troponin than conventional assays. We examined the 
      effects of self-reported cocaine use to determine whether those with acute 
      cocaine use being evaluated for ACS are more likely to have elevated hsTnI than 
      those nonusers being evaluated for ACS. METHODS: We conducted a sub-analysis of a 
      prospective cohort of ED patients evaluated for acute coronary syndrome. Recent 
      cocaine use was determined by structured patient interviews. High-sensitivity 
      troponin (Abbott) and conventional troponin I (Abbott, cTnI) were measured on 
      samples drawn at presentation. Urine toxicology screen for cocaine metabolite was 
      obtained at the discretion of treating clinicians. RESULTS: Of 1862 patients 
      enrolled, 444 reported prior cocaine use and 99 reported cocaine use within the 
      preceding month. Median hsTn in patients with last cocaine use within 24 h, 2-7 
      days, 1 week-1 month, >1 month, and no prior cocaine use were: 9 (IQR: 3-17) 
      ng/L, 6 (IQR: 3-24.3) ng/L, 6 (IQR: 3-89.5) ng/L, 3 (IQR: 3-18.5) ng/L and 3 
      (IQR: 3-17) ng/L, respectively. Urine toxicology assays (UTox) for cocaine were 
      performed in 640 (34.4%) patients. The median hsTn for those who were UTox+, 
      UTox - and those without a UTox were: 9 ng/L (IQR: 3-48.5), 9 ng/L (IQR: 3-40) 
      and 3 ng/L (IQR: 3-12), respectively. There were no differences in the prevalence 
      of new troponin elevations (hsTn >99th percentile but cTnI <99th percentile) in 
      those with recent cocaine use compared to those without recent cocaine use. 
      CONCLUSIONS: In this first investigation of hsTn in patients with self-reported 
      recent cocaine use, we have determined that hsTn does not lead to an increase in 
      the prevalence of troponin elevation in cocaine users.
FAU - Jordan, Candice D
AU  - Jordan CD
AD  - a Department of Emergency Medicine , Johns Hopkins University School of Medicine 
      , Baltimore , MD , USA.
FAU - Korley, Frederick K
AU  - Korley FK
AD  - b Department of Emergency Medicine , University of Michigan Medical School , Ann 
      Arbor , MI , USA.
FAU - Stolbach, Andrew I
AU  - Stolbach AI
AD  - a Department of Emergency Medicine , Johns Hopkins University School of Medicine 
      , Baltimore , MD , USA.
LA  - eng
PT  - Journal Article
DEP - 20170209
PL  - England
TA  - Clin Toxicol (Phila)
JT  - Clinical toxicology (Philadelphia, Pa.)
JID - 101241654
RN  - 0 (Biomarkers)
RN  - 0 (Troponin I)
RN  - I5Y540LHVR (Cocaine)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*diagnosis/urine
MH  - Aged
MH  - Biomarkers/blood/urine
MH  - Cocaine/administration & dosage/*adverse effects/urine
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardium/metabolism
MH  - Prospective Studies
MH  - Self Report
MH  - Sensitivity and Specificity
MH  - Troponin I/*blood/*urine
OTO - NOTNLM
OT  - Cocaine toxicity
OT  - cocaine MI
OT  - cocaine cardiotoxicty
EDAT- 2017/04/20 06:00
MHDA- 2017/04/26 06:00
CRDT- 2017/04/20 06:00
PHST- 2017/04/20 06:00 [entrez]
PHST- 2017/04/20 06:00 [pubmed]
PHST- 2017/04/26 06:00 [medline]
AID - 10.1080/15563650.2017.1285404 [doi]
PST - ppublish
SO  - Clin Toxicol (Phila). 2017 Jun;55(5):332-337. doi: 10.1080/15563650.2017.1285404. 
      Epub 2017 Feb 9.