Cocaine-associated myocardial infarction. Clinical safety of thrombolytic therapy. Cocaine Associated Myocardial Infarction (CAMI) Study Group.
OBJECTIVE
To determine the safety of thrombolytic use in patients with cocaine-associated myocardial infarction.


METHODS
Retrospective cross-sectional survey.


METHODS
Twenty-nine acute care institutions.


METHODS
Patients who sustained cocaine-associated myocardial infarction from 1987 to 1993 were identified through medical record review. Those who received thrombolytic therapy (n = 25) were compared with those who met electrocardiographic TIMI criteria but did not receive thrombolytic therapy (n = 41).


METHODS
None.


RESULTS
Both groups of patients were similar with respect to age, gender, race, cardiac risk factors, time from last cocaine use until presentation, and duration of chest pain at the time of presentation (p > 0.20). There were no major complications or deaths in patients who received thrombolytic therapy (95% confidence interval, 0 to 12%). Minor complications occurred in only two patients. The presence or absence of clinical criteria for reperfusion was noted in the charts of 21 patients who received thrombolytic therapy: 67% were believed to reperfuse. The patients who did and did not receive thrombolytic therapy had similar median peak creatine kinase-MB (CK-MB) levels (180 vs 154 mg/dL, p = NS) and time until peak CK-MB (11.3 vs 13.6 h; p = NS).


CONCLUSIONS
Thrombolytic therapy for cocaine-associated myocardial infarction appears to be safe. It remains unclear whether thrombolytic therapy is an important therapeutic intervention for patients with cocaine-associated myocardial infarction. Further study on efficacy is recommended prior to routine use.
Hollander
J E
JE
University Medical Center, State University of New York Health Sciences Center, Stony Brook, USA.
Burstein
J L
JL
Hoffman
R S
RS
Shih
R D
RD
Wilson
L D
LD
D000328:Adult; D003042:Cocaine / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000188:drug therapy; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D003042:Cocaine