Increased incidence of stent thrombosis in patients with cocaine use.
BACKGROUND
Coronary stent thrombosis is a rare occurrence in the era of dual-antiplatelet therapy. It is not known whether patients who use cocaine have a higher risk of thrombosis following coronary stent placement.


METHODS
We studied 247 consecutive patients who underwent coronary stent placement at an inner-city hospital.


RESULTS
Twelve patients (4.9%) were actively using cocaine at the time of PCI. Of these twelve patients, four patients presented with stent thrombosis (33%) at a mean of 51 +/- 40 days (median 45 days), after the index revascularization procedure. Only 2 of the 235 patients without documented cocaine use (0.85%) had stent thrombosis during the same period (P < 0.0001).


CONCLUSIONS
The patients who actively use cocaine have a markedly higher risk of stent thrombosis when compared with patients without a documented history of cocaine use. We discuss various factors that potentially predispose cocaine users to stent thrombosis.
Karlsson
Gudjon
G
Cardiac Catheterization Laboratories, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Rehman
Jalees
J
Kalaria
Vijay
V
Breall
Jeffrey A
JA
D000787:Angina Pectoris / Q000209:etiology / Q000517:prevention & control; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D019970:Cocaine-Related Disorders / Q000150:complications*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin