Acute coronary syndrome and cocaine use: 8-year prevalence and inhospital outcomes.
OBJECTIVE
The use of cocaine as a recreational drug has increased in recent years. The aims of this study were to analyse the prevalence and in-hospital evolution of acute coronary syndrome (ACS) associated with cocaine consumption (ACS-ACC).


RESULTS
Prospective analysis of ACS patients admitted to a coronary care unit from January 2001 to December 2008. During the study period, 2752 patients were admitted for ACS, and among these 479 were ≤50 years of age. Fifty-six (11.7%) patients had a medical history of cocaine use with an increase in prevalence from 6.8% in 2001 to 21.7% in 2008 (P = 0.035). Among patients younger than 30 years of age, 25% admitted to being users compared with 5.5% of those aged 45-50 years (P = 0.007). Similarly, the prevalence of positive urine tests for cocaine was four times higher in the younger patients (18.2 vs. 4.1%, P = 0.035). Acute coronary syndrome associated with cocaine consumption patients (n = 24; those who had a positive urine test for cocaine or who admitted to being users upon admission) had larger myocardial infarcts as indicated by troponin I levels (52.9 vs. 23.4 ng/mL, P < 0.001), lower the left ventricular ejection fraction (44.5 vs. 52.2%, P = 0.049), and increased in-hospital mortality (8.3 vs. 0.8%, P = 0.030).


CONCLUSIONS
The association between cocaine use and ACS has increased significantly over the past few years. Young adults with ACS-ACC that require admission to the coronary care unit have greater myocardial damage and more frequent complications.
Cardiology Service, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, Spain.
Xavier
X
Carrillo
Antoni
A
Curós
Robert
R
Muga
Jordi
J
Serra
Arantza
A
Sanvisens
Antoni
A
Bayes-Genis
D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000453:epidemiology; D003325:Coronary Care Units / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome