Traditional risk factors and acute myocardial infarction in patients hospitalized with cocaine-associated chest pain.
BACKGROUND
Cocaine causes coronary artery constriction and may cause acute myocardial infarction (AMI). The role of traditional coronary risk factors in cocaine-associated myocardial infarction is unclear.


OBJECTIVE
We hypothesized that traditional risk factors play a major role in predicting AMI in patients admitted with cocaine-associated chest pain


METHODS
After reviewing 165 admissions for chest pain in patients with a history of recent cocaine use and/or a positive drug screen from January 2001 to December 2004, we identified 151 patients with information available on at least 6 of the following 7 risk factors: gender, hypertension, hyperlipidemia, diabetes, smoking, family history of coronary artery disease (CAD) and known CAD. AMI was diagnosed using WHO criteria. A risk score was calculated on the basis of the number of risk factors, gender and age. Association of AMI was evaluated with the individual risk factors and with the risk score.


RESULTS
AMI was identified in 21 patients (14%). All patients diagnosed with AMI were smokers. Continuous risk score (p < 0.0001), highest vs. lowest quartile of risk score (p = 0.007), known CAD, age, hyperlipidemia and family history of CAD were individually associated with the diagnosis of AMI (p>or=0.05). Each quartile of risk score was associated with increased odds of the diagnosis of AMI and score of 8 or higher was statistically significant.


CONCLUSIONS
Several traditional risk factors are associated with the diagnosis of AMI among patients hospitalized with cocaine-associated chest pain and increasing risk factor score was associated with increasing odds of AMI diagnosis.
Bansal
Darpan
D
Division of Cardiovascular Medicine, Department of Internal Medicine, Little Rock, Arkansas 72205-7199, USA.
Eigenbrodt
Marsha
M
Gupta
Ekta
E
Mehta
J L
JL
D000328:Adult; D000367:Age Factors; D000787:Angina Pectoris / Q000209:etiology*; D003042:Cocaine / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications; D005260:Female; D006760:Hospitalization; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D016017:Odds Ratio; D010375:Pedigree; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
D014662:Vasoconstrictor Agents; D003042:Cocaine