Cocaine-associated Chest Pain How Common Is Myocardial Infarction?
dc.contributor.author | Weber, Jim Edward | en_US |
dc.contributor.author | Chudnofsky, Carl R. | en_US |
dc.contributor.author | Boczar, Michael E. | en_US |
dc.contributor.author | Boyer, Edward W. | en_US |
dc.contributor.author | Wilkerson, Mark D. | en_US |
dc.contributor.author | Hollander, Judd E. | en_US |
dc.date.accessioned | 2010-06-01T18:41:49Z | |
dc.date.available | 2010-06-01T18:41:49Z | |
dc.date.issued | 2000-08 | en_US |
dc.identifier.citation | Weber, Jim Edward; Chudnofsky, Carl R.; Boczar, Michael; Boyer, Edward W.; Wilkerson, Mark D.; Hollander, Judd E. (2000). "Cocaine-associated Chest Pain How Common Is Myocardial Infarction?." Academic Emergency Medicine 7(8): 873-877. <http://hdl.handle.net/2027.42/71896> | en_US |
dc.identifier.issn | 1069-6563 | en_US |
dc.identifier.issn | 1553-2712 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/71896 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=10958126&dopt=citation | en_US |
dc.description.abstract | Objective: Prior studies addressing the incidence of acute myocardial infarction (AMI) in patients with cocaine-associated chest pain have found divergent results. Previous prospective studies, which found approximately a 6% incidence of AMI, have been criticized for selection bias. This study sought to determine the rate of AMI in patients with cocaine-associated chest pain. Methods: All patients seen in an urban university-affiliated hospital between July 1996 and February 1998 were identified by ICD-9 medical records search for cocaine use and chest pain/acute coronary syndromes. In this system, all faculty admit all patients with cocaine-associated chest pain for at least 23-hour observation periods. Data collected included demographics, medical and cocaine use history, presenting characteristics, hospital course, cardiovascular complications, and diagnostic tests using a 119-item closed-question data instrument with high interrater reliability. The main outcome measure was AMI according to World Health Organization (WHO) criteria. Results: There were 250 patients identified with a mean age of 33.5 ± 8.5 years; 77% were male; 84% were African American. Of 196 patients tested, 185 had cocaine or cocaine metabolites in the urine (94%). The incidence of cardiac risk factors were: hypercholesterolemia, 8%; diabetes, 6%; family history, 34%; hypertension, 26%; tobacco use, 77%; prior MI, 6%; and prior chest pain, 40%. Seventy-seven percent admitted to cocaine use in the preceding 24 hours: crack, 85%; IV, 2%; nasal, 6%. Twenty-five patients (10%) had electrocardiographic evidence of ischemia. A total of 15 patients experienced an AMI (6%; 95% CI = 4.1% to 8.9%) using WHO criteria. Complications were infrequent: bradydysrrhythmias, 0.4%; congestive heart failure, 0.4%; supraventricular tachycardia, 1.2%; sustained ventricular tachycardia, 0.8%. Conclusion: The incidence of AMI was 6% in patients with cocaine-associated chest pain. This result is identical to that found in prior prospective studies. | en_US |
dc.format.extent | 56634 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Publishing Ltd | en_US |
dc.rights | 2000 Society for Academic Emergency Medicine | en_US |
dc.subject.other | Cocaine | en_US |
dc.subject.other | Acute Coronary Syndrome | en_US |
dc.subject.other | Acute Myocardial Infarction | en_US |
dc.subject.other | Emergency Department | en_US |
dc.subject.other | Electrocardiogram | en_US |
dc.title | Cocaine-associated Chest Pain How Common Is Myocardial Infarction? | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Medicine (General) | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Departments of Emergency Medicine, Hurley Medical Center, Flint, MI, and the University of Michigan, Ann Arbor, MI (JEW, CRC, MB, MDW) | en_US |
dc.contributor.affiliationother | University of Pennsylvania, Philadelphia, PA (EWB, JEH). | en_US |
dc.identifier.pmid | 10958126 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/71896/1/j.1553-2712.2000.tb02064.x.pdf | |
dc.identifier.doi | 10.1111/j.1553-2712.2000.tb02064.x | en_US |
dc.identifier.source | Academic Emergency Medicine | en_US |
dc.identifier.citedreference | Mittleman, MA, Mintzer, D, Maclure, M, Tofler, GH, Sherwood, JB, Muller, JE. Triggering of myocardial infarction by cocaine. Circulation. 1999; 99: 2737 – 41. | en_US |
dc.identifier.citedreference | Minor, RL, Scott, BD, Brown, DD, Winford, MD. Cocaine induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991; 115: 797 – 806. | en_US |
dc.identifier.citedreference | Smith HW, III, Liberman, HA, Brody, SL, Battey, LL, Donohue, BC, Morris, DC. Acute myocardial infarction temporally related to cocaine use. Clinical, angiographic, and pathophysiologic observations. Ann Intern Med. 1987; 107: 13 – 8. | en_US |
dc.identifier.citedreference | Williams, MJ, Stewart, RA. Serial angiography in cocaine-induced myocardial infarction. Chest. 1997; 111: 822 – 4. | en_US |
dc.identifier.citedreference | Kontos, MC, Schmidt, KL, Nicholson, CS, et al. Myocardial perfusion imaging with technetium-99m sestamibi in patients with cocaine associated chest pain. Ann Emerg Med. 1999; 33: 639 – 45. | en_US |
dc.identifier.citedreference | Brody, SL, Slovis, CM, Wrenn, KD. Cocaine related medical problems: consecutive series of 233 patients. Am J Med. 1990; 88: 325 – 31. | en_US |
dc.identifier.citedreference | Zimmerman, JL, Dellinger, RP, Majid, PA. Cocaine associated chest pain. Ann Emerg Med. 1991; 20: 611 – 5. | en_US |
dc.identifier.citedreference | Gitter, MJ, Goldsmith, SR, Dunbar, DN, Sharkey, SW. Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med. 1991; 115: 277 – 82. | en_US |
dc.identifier.citedreference | Amin, M, Gableman, G, Karpel, J, Buttrick, P. Acute myocardial infarction and chest pain syndromes after cocaine use. Am J Cardiol. 1990; 66: 1434 – 7. | en_US |
dc.identifier.citedreference | Tokarski, GN, Paganussi, P, Urbanski, R, et al. An evaluation of cocaine induced chest pain. Ann Emerg Med. 1990; 19: 1088 – 92. | en_US |
dc.identifier.citedreference | Hollander, JE, Hoffman, RS, Gennis, P, et al. Prospective multicenter evaluation of cocaine associated chest pain. Acad Emerg Med. 1994; 1: 330 – 9. | en_US |
dc.identifier.citedreference | Hollander, JE, Hoffman, RS, Burstein, MD, et al. Cocaine associated myocardial infarction: mortality and complications. Arch Intern Med. 1995; 155: 1081 – 6. | en_US |
dc.identifier.citedreference | Hollander, JE, Lozano M., Goldstein E, et al. Variations in the electrocardiograms of young adults: are revised criteria for thrombolysis necessary? Acad Emerg Med. 1994; 1: 94 – 102. | en_US |
dc.identifier.citedreference | Tunstall-Pedoe, H, Kuulasmaa, K, Amouyel, P, Arveiler, D, Rajakangas, AM, Pajak, A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994; 90: 583 – 61. | en_US |
dc.identifier.citedreference | Hollander, JE, Todd, KH, Green, G, et al. Chest pain associated with cocaine: an assessment of prevalence in suburban and urban emergency departments. Ann Emerg Med. 1995; 26: 671 – 6. | en_US |
dc.identifier.citedreference | Hollander, JE, Hoffman, RS. Cocaine induced myocardial infarction: an analysis and review of the literature. J Emerg Med. 1992; 10: 169 – 77. | en_US |
dc.identifier.citedreference | Gibler, WB, Young, GP, Hedges, JR, et al. Acute myocardial infarction in chest pain patients with non-diagnostic ECGs: serial CPK-MB sampling in the emergency department. Ann Emerg Med. 1992; 21: 504 – 12. | en_US |
dc.identifier.citedreference | Hollander, JE. Management of cocaine associated myocardial ischemia. N Engl J Med. 1995; 333: 1267 – 72. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.