title: Outcomes of Patients With Cocaine Induced Chest Pain in An Inner City Hospital.
abstract: BACKGROUND
  Cocaine induced chest pain is a major reason for admission in Safety Net Hospitals in the United States. The majority of patients admitted undergo extensive work-up leading to enormous economic burden. We hypothesize that in individuals with low risk, cocaine does not further increase adverse cardiovascular outcomes.
  
  
  METHODS
  We conducted a retrospective chart review of all patients admitted with chest pain to our hospital between 07/01/09 and 06/30/10. We excluded patients with modifiable risk factors for coronary artery disease (CAD). The study population was divided into cocaine and non-cocaine group based on urine drug screen. We analyzed data including demographic, laboratory, cardiac testing, detection of CAD, length of stay and mortality rates.
  
  
  RESULTS
  A total of 426 individuals matched our inclusion and exclusion criteria and were considered to have no known modifiable cardiac risk factors; 54 in cocaine group and 372 in non-cocaine group. Based on physician discretion, 41(76%) in the cocaine group and 239(64%) in the non-cocaine group underwent various modalities of cardiac testing. Cardiac testing was positive in 6(2.5%) patients in non-cocaine group and none in the cocaine group (p=0.597). There was no significant difference between length of stay and in-hospital mortality between the two groups.
  
  
  CONCLUSIONS
  In individuals at low risk for CAD, cocaine use resulted in higher rate of cardiac testing. However, there is no difference in prevalence of CAD and in-hospital mortality between the two groups. We conclude that cocaine does not increase adverse outcomes in patients with low risk for CAD.
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Atoui
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Fida
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Suresh Kumar
authors.initials: SK
authors.lastname: Nayudu
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Mariela
authors.initials: M
authors.lastname: Glandt
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Chilimuri
keywords: Chest Pain; Cocaine; Outcome