Characteristics, Management, and Outcomes of Cocaine-Positive Patients With Acute Coronary Syndrome (from the National Cardiovascular Data Registry)
Characteristics, Management, and Outcomes of Cocaine-Positive Patients With Acute Coronary Syndrome (from the National Cardiovascular Data Registry)
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DOI：
10.1016/j.amjcard.2013.11.023
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发表时间：
2014-03-01
影响因子：
2.8
通讯作者：
Arora, Rohit
中科院分区：
文献类型：
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作者：
Gupta, Navdeep;Washam, Jeffrey B.;Arora, Rohit
尽管摄入可卡因可能导致或促成心肌梗塞 (MI)，但目前很少有数据描述与可卡因相关的 MI。我们描述了急性冠脉治疗和干预结果网络登记指南获取指南 (ACTION Registry-GWTG) 计划中 MI 患者和近期使用可卡因的患者的特征、治疗和结果。研究人群为 2008 年 7 月至 2010 年 3 月 31 日期间在美国心脏病学会 ACTION 登记处-GWTG 注册的 102,952 名患者，来自美国 460 个地点。可卡因暴露定义为过去 72 小时内自我报告的可卡因使用情况或可卡因尿检呈阳性。人口统计和病史、表现特征、治疗和院内结果均以标准病例记录表报告。共有 924 名患者（0.9%）可卡因呈阳性。与可卡因阴性患者相比，可卡因阳性患者更年轻，并且主要是心血管危险因素较少的男性。可卡因阳性组出现 ST 段抬高型心肌梗死 (STEM!)（46.3% vs 39.7%）和心源性休克的比例较高，但多支冠状动脉疾病的比例较低（53.3% vs 64.5%）。 24 小时内使用 β 受体阻滞剂（85.8% vs 90.1%，p
Although cocaine ingestion may cause or contribute to myocardial infarction (MI), few contemporary data are available describing cocaine-associated MI. We describe the characteristics, management, and outcomes of patients with MI and recent cocaine use from the Acute Coronary Treatment and Intervention Outcomes Network Registry Get With The Guidelines (ACTION Registry-GWTG) program. The study population was 102,952 patients enrolled in the American College of Cardiology ACTION Registry-GWTG from July 2008 to March 31, 2010 from 460 sites across the United States. Cocaine exposure was defined as self-reported cocaine use within the last 72 hours or a positive urine test for cocaine. Demographics and medical history, presenting characteristics, treatments, and in-hospital outcomes were reported on a standard case record form. A total of 924 patients (0.9%) were cocaine positive. Compared with cocaine-negative patients, cocaine-positive patients were younger and predominantly men with fewer cardiovascular risk factors. There was a higher percentage of ST elevation myocardial infarction (STEM!) (46.3% vs 39.7%) and cardiogenic shock at presentation in the cocaine-positive group, but the percentage of multivessel coronary artery disease was lower (53.3% vs 64.5%). Beta blockers within 24 hours (85.8% vs 90.1%, p