Triggering of Myocardial Infarction by Cocaine
- 1 June 1999
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 99 (21), 2737-2741
- https://doi.org/10.1161/01.cir.99.21.2737
Abstract
Background —Cocaine has been implicated as a trigger of acute myocardial infarction in patients with and those without underlying coronary atherosclerosis. However, the magnitude of the increase in risk of acute myocardial infarction immediately after cocaine use remains unknown. Methods and Results —In the Determinants of Myocardial Infarction Onset Study, we interviewed 3946 patients (1282 women) with acute myocardial infarction an average of 4 days after infarction onset. Data were collected on the use of cocaine and other potential triggers of myocardial infarction. We compared the reported use of cocaine in the hour preceding the onset of myocardial infarction symptoms with its expected frequency by using self-matched control data based on the case-crossover study design. Of the 3946 patients interviewed, 38 (1%) reported cocaine use in the prior year and 9 reported use within the 60 minutes preceding the onset of infarction symptoms. Compared with nonusers, cocaine users were more likely to be male (87% vs 67%, P =0.01), current cigarette smokers (84% vs 32%, P P P Conclusions —Cocaine use is associated with a large abrupt and transient increase in the risk of acute myocardial infarction in patients who are otherwise at relatively low risk. This finding suggests that studying the pathophysiological changes produced by cocaine may provide insights into the mechanisms by which myocardial infarction is triggered by other stressors.Keywords
This publication has 35 references indexed in Scilit:
- Chest Pain Associated With Cocaine: An Assessment of Prevalence in Suburban and Urban Emergency DepartmentsAnnals of Emergency Medicine, 1995
- Intraventricular thrombus after cocaine-induced myocardial infarctionAmerican Heart Journal, 1995
- Cocaine induces rapid loss of intracellular free Mg2+ in cerebral vascular smooth muscle cellsEuropean Journal of Pharmacology: Molecular Pharmacology, 1993
- The Pathogenesis of Coronary Artery Disease and the Acute Coronary SyndromesNew England Journal of Medicine, 1992
- The Pathogenesis of Coronary Artery Disease and the Acute Coronary SyndromesNew England Journal of Medicine, 1992
- Acute myocardial infarction and chest pain syndromes after cocaine useThe American Journal of Cardiology, 1990
- Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: Enhanced vasoconstriction at sites of significant stenosesJournal of the American College of Cardiology, 1990
- Cocaine-Induced Coronary-Artery VasoconstrictionNew England Journal of Medicine, 1989
- Coronary artery spasm, cardiac arrest, transient electrocardiographic Q waves and stunned myocardium in cocaine-associated acute myocardial infarctionThe American Journal of Cardiology, 1988
- Coronary arteriographic findings in cocaine abuse-induced myocardial infarctionCatheterization and Cardiovascular Diagnosis, 1988