Cardiovascular Effects of Cocaine

Schwartz, Bryan G.; Rezkalla, Shereif H.; Kloner, Robert A.

doi:10.1161/circulationaha.110.940569

Cited by 341 publications

(316 citation statements)

References 127 publications

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“…The use of cocaine is associated with both acute and chronic complications that may involve any system, but the most common system affected is cardiovascular one (2)(3)(4)(5)(6). Cocain related complications include: cardiac (myocardial ischaemia, coronary artery spasm, myocardial infarction (MI), atherosclerosis, myocarditis, cardiomyopathy, arrhythmia, hypertension, and endocarditis); vascular (aortic dissection and rupture, vasculitis); gastrointestinal (mesenteric ischaemia or infarction, perforation); pulmonary (pulmonary oedema, pulmonary infarction, and haemoptysis); genitourinary and obstetric (renal and testicular infarction, abruptio placentae, spontaneous abortion, prematurity, and growth retardation); neurological (seizures, migraine, cerebral infarction, and intracranial hemorrhage); musculoskeletal and dermatological (rhabdomyolysis, skin ischemia, superficial and deep venous thrombosis, and thrombophlebitis (2-6).…”

Section: Introductionmentioning

confidence: 99%

Cocaine cardiomyopathy: A case report

Greco¹,

Zhivadinovik²

2014

SANAMED

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Abstract:Cocaine is the second most common illicit drug used and the most frequent cause of drug related deaths. The use of cocaine is associated with both, acute and chronic complications, that may involve any system, but the most common system affected is cardiovascular one. Cocaine cardiomyopathy may result from the use of cocaine.This article presents a first case in Republic of Macedonia of 24-year-old male with reversible cocaine-related cardiomyopathy. Clinical presentation, laboratory, X-ray, ultrasound findings and treatment are reviewed.

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Section: Introductionmentioning

confidence: 99%

Cocaine cardiomyopathy: A case report

Greco¹,

Zhivadinovik²

2014

SANAMED

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“…For example, in a study of 194 006 patients with an ICD, Saxon and colleagues reported an ICD discharge rate of ≈18% over a similar follow‐up period 44. The mechanisms for the small differences in ICD discharge rate in our presumed uninfected population are unclear but are likely, in part, mediated by a high background prevalence of diabetes mellitus,46 cocaine use,26 and the lower rate of cardiac resynchronization therapy use 47. Finally, the interpretation of the ICD data was derived from the EHR from the interpretation of a board‐certified electrophysiologist and was not independently reviewed.…”

Section: Discussionmentioning

confidence: 91%

“…For example, late gadolinium enhancement has been reported in >30% of patients with a nonischemic cardiomyopathy and >80% of patients with an ischemic cardiomyopathy 25. Cocaine use leads to heightened sympathetic tone,26 blocks sodium channels,26 and can lead to myocardial fibrosis 24. The use of cocaine may also affect the prescription of standard HF medications, which reduce the burden of ventricular arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV

Alvi

Neilan

Tariq

et al. 2018

JAHA

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BackgroundPeople living with HIV (PHIV) are at an increased risk for sudden cardiac death, and implantable cardioverter‐defibrillators (ICDs) prevent SCD. There are no data on the incidence, predictors, and effects of ICD therapies among PHIV.Methods and ResultsWe compared ICD discharge rates between 59 PHIV and 267 uninfected controls. For PHIV, we tested the association of traditional cardiovascular risk factors and HIV‐specific parameters with an ICD discharge and then tested whether an ICD discharge among PHIV was associated with cardiovascular mortality or an admission for heart failure. The indication for ICD insertion was similar among groups. Compared with controls, PHIV with an ICD were more likely to have coronary artery disease and to use cocaine. In follow‐up, PHIV had a higher ICD discharge rate (39% versus 20%; P=0.001; median follow‐up period, 19 months). Among PHIV, cocaine use, coronary artery disease, QRS duration, and higher New York Heart Association class were associated with an ICD discharge. An ICD discharge had a prognostic effect, with a subsequent 1.7‐fold increase in heart failure admission and a 2‐fold increase in cardiovascular mortality, an effect consistent across racial/ethnic and sex categories.Conclusions ICD discharge rates are higher among PHIV compared with uninfected controls. Among PHIV, cocaine use and New York Heart Association class are associated with increased ICD discharge, and an ICD discharge is associated with a subsequent increase in admission for heart failure and cardiovascular mortality.

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“…Desde el punto de vista angiográfico, los IAMC tienen mayor reporte de arterias coronarias sin lesiones significativas que van desde un 25 a un 40%, menos lesiones de 3 vasos 4 , y más incidencia de trombos [3][4][5][6][7][8][9][10][11][12][13][14] . Existiría una enfermedad ateroesclerótica más difusa con más cantidad de placas, pero estenosis menos severas 15 . Estudios postmortem encuentran lesiones en vaso de pequeño calibre con hipertrofia de la media, proliferación de íntima y fibrosis periadventicial 16 .…”

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