Cocaine Use Doesn't Raise In-Hospital Mortality With MI
Cocaine-positive MI patients are younger, mainly men, with fewer cardiovascular risk factors
WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- Cocaine users with myocardial infarction (MI) are younger and generally have fewer risk factors, and do not have increased odds of in-hospital mortality, according to research published in the March 1 issue of The American Journal of Cardiology.
Navdeep Gupta, M.D., from the Medical College of Wisconsin in Milwaukee, and colleagues describe the characteristics, management, and outcomes of patients with MI and recent cocaine use. Data were assessed for 102,952 participants in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines program.
The researchers found that 924 patients (0.9 percent) were cocaine positive. Cocaine-positive patients were younger and predominantly men, with fewer cardiovascular risk factors than cocaine-negative patients. In the cocaine-positive group there was a higher percentage of ST-segment elevation myocardial infarction (STEMI; 46.3 versus 39.7 percent) and cardiogenic shock at presentation, as well as a lower percentage of multivessel coronary artery disease (53.3 versus 64.5 percent). Cocaine-positive patients less commonly received β-blockers within 24 hours (P < 0.0001) and drug-eluting stents (P < 0.0001 in both patients with non-STEMI and STEMI). There was no significant difference in in-hospital mortality for cocaine-positive and cocaine-negative patients (adjusted odds ratio, 1.00; P = 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," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.