Current Approach and Treatment of Myocardial Infarction Associated with Cocaine Use
Main Article Content
Abstract
Introduction: The global crisis of illicit substance consumption, particularly cocaine, extends beyond individual users, impacting social, cultural, and institutional levels. Cocaine use is associated with a myriad of illicit activities and significantly affects public health, especially in underdeveloped countries. This study examines the cardiovascular risks linked to cocaine use, focusing on conditions such as chest pain and acute myocardial infarction.
Methodology: A comprehensive review of the literature was conducted to explore the epidemiology, pathophysiology, and treatment strategies for cocaine-associated cardiovascular events. Data on cocaine use prevalence and related cardiovascular incidents were analyzed, alongside mechanisms of cocaine-induced myocardial damage and treatment protocols.
Results: Cocaine use has increased, particularly among young adults, leading to higher prevalence rates of cardiovascular events, including acute myocardial infarction. Cocaine induces vasoconstriction, arrhythmias, and oxidative stress, contributing to myocardial ischemia and infarction. The literature reveals a significant incidence of severe coronary atherosclerosis and multivessel disease among young cocaine users experiencing acute myocardial infarction. Immediate intervention strategies, including dual antiplatelet therapy and percutaneous coronary intervention, are essential but must be tailored to the unique challenges posed by cocaine's effects.
Conclusions: Cocaine elevates the risk of severe cardiovascular events, necessitating targeted prevention and treatment strategies. The management of acute myocardial infarction in cocaine users requires a personalized approach, considering the drug's complex impact on cardiovascular health. Preventive measures and early intervention are crucial to mitigating the heightened risk of myocardial infarction and other cardiac events in this population.
Article Details
How to Cite
MIRANDA, Paula; VEAS, Nicolas.
Current Approach and Treatment of Myocardial Infarction Associated with Cocaine Use.
Medical Research Archives, [S.l.], v. 12, n. 7, july 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5623>. Date accessed: 21 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i7.5623.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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Appelboom T. La consommation de la coca dans l'Histoire [Consumption of coca in history]. Verh K Acad Geneeskd Belg. 1991;53(5):497-505.
Ruetsch YA, Böni T, Borgeat A. From cocaine to ropivacaine: the history of local anesthetic drugs. Curr Top Med Chem. 2001 Aug;1(3):175-82.
Drake LR, Scott PJH. DARK Classics in Chemical Neuroscience: Cocaine. ACS Chem Neurosci. 2018 Oct 17;9(10):2358-2372.
Grzybowski A. Historia kokainy w medycynie i jej znaczenie dla odkrycia róznych form znieczulenia [The history of cocaine in medicine and its importance to the discovery of the different forms of anaesthesia]. Klin Oczna. 2007;109(1-3):101-5.
Ryan SA. Cocaine Use in Adolescents and Young Adults. Pediatr Clin North Am. 2019 Dec;66(6):1135-1147.
Johnston L.D., Miech R.A., O’Malley P.M., et al: Monitoring the future national survey results on drug use: 1975-2017: overview, key findings on adolescent drug use. Ann Arbor (MI): Institute for Social Research, The University of Michigan, 2018.
Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report
Canadian Drug Summary: Cocaine (2022); Canadian Centre on Substance Use and Addiction.
Cocaine – the current situation in Europe; European Drug Report 2023.
Drug market trends; United Nations Office on Drugs and Crime.
Quinceavo estudio de drogas en la población general, SENDA.
Ritz MC, Cone EJ, Kuhar MJ. Cocaine inhibition of ligand binding at dopamine, norepinephrine and serotonin transporters: a structure-activity study. Life Sci. 1990;46(9):635-45.
Zhu F, Liu L, Li J, Liu B, Wang Q, Jiao R, Xu Y, Wang L, Sun S, Sun X, Younus M, Wang C, Hokfelt T, Zhang B, Gu H, Xu ZD, Zhou Z. Cocaine increases quantal norepinephrine secretion through NET-dependent PKC activation in locus coeruleus neurons. Cell Rep. 2022 Aug 16;40(7):111199.
Haas C, Karila L, Lowenstein W. Addiction a la cocaïne et au "crack": un problème de santé publique qui s'aggrave [Cocaine and crack addiction: a growing public health problem]. Bull Acad Natl Med. 2009 Apr;193(4):947-62; discussion 962-3.
Pradhan L, Mondal D, Chandra S, Ali M, Agrawal KC. Molecular analysis of cocaine-induced endothelial dysfunction: role of endothelin-1 and nitric oxide. Cardiovasc Toxicol. 2008 Dec;8(4):161-71.
Peruch M, Giacomello E, Radaelli D, Concato M, Addobbati R, Fluca AL, Aleksova A, D'Errico S. Subcellular Effectors of Cocaine Cardiotoxicity: All Roads Lead to Mitochondria-A Systematic Review of the Literature. Int J Mol Sci. 2023 Sep 25;24(19):14517.
Boess F, Ndikum-Moffor FM, Boelsterli UA, Roberts SM. Effects of cocaine and its oxidative metabolites on mitochondrial respiration and generation of reactive oxygen species. Biochem Pharmacol. 2000 Sep 1;60(5):615-23. doi: 10.1016/s0006-2952(00)00355-5. PMID: 10927019.
Havakuk O, Rezkalla SH, Kloner RA. The Cardiovascular Effects of Cocaine. J Am Coll Cardiol. 2017 Jul 4;70(1):101-113.
Hantson P. Mechanisms of toxic cardiomyopathy. Clin Toxicol (Phila). 2019 Jan;57(1):1-9.
Maceira AM, Guardiola S, Ripoll C, Cosin-Sales J, Belloch V, Salazar J. Detection of subclinical myocardial dysfunction in cocaine addicts with feature tracking cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2020 Sep 28;22(1):70.
Maceira AM, Ripoll C, Cosin-Sales J, Igual B, Gavilan M, Salazar J, Belloch V, Pennell DJ. Long term effects of cocaine on the heart assessed by cardiovascular magnetic resonance at 3T. J Cardiovasc Magn Reson. 2014 Apr 23;16(1):26.
Nash E, Roberts DM, Jamshidi N. Reverse Takotsubo Cardiomyopathy Precipitated by Chronic Cocaine and Cannabis Use. Cardiovasc Toxicol. 2021 Dec;21(12):1012-1018.
Lai H, Bluemke DA, Fishman EK, Gerstenblith G, Celentano DD, Treisman G, Foster P, Mandler R, Khalsa J, Chen S, Bhatia S, Kolossváry M, Lai S. High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis. J Addict Med. 2023 Mar-Apr 01;17(2):147-154.
Wang J, Patel PS, Andhavarapu S, Bzihlyanskaya V, Friedman E, Jeyaraju M, Palmer J, Raffman A, Pourmand A, Tran QK. Prevalence of myocardial infarction among patients with chest pain and cocaine use: A systematic review and meta-analysis. Am J Emerg Med. 2021.
Hollander JE, Hoffman RS, Gennis P, Fairweather P, DiSano MJ, Schumb DA, Feldman JA, Fish SS, Dyer S, Wax P, Whelan C, Schwartzwald E. Prospective multicenter evaluation of cocaine-associated chest pain. Cocaine Associated Chest Pain (COCHPA) Study Group. Acad Emerg Med. 1994; 1: 330–339.
Pergolizzi JV Jr, Magnusson P, LeQuang JAK, Breve F, Varrassi G. Cocaine and Cardiotoxicity: A Literature Review. Cureus. 2021 Apr 20;13(4):e14594.
Patrizi, R, Pasceri, V, Sciahbasi, A. et al. Evidence of Cocaine-Related Coronary Atherosclerosis in Young Patients With Myocardial Infarction. J Am Coll Cardiol. 2006 May, 47 (10) 2120–2122.
Patrizi R, Pasceri V, Sciahbasi A, Summaria F, Rosano GM, Lioy E. Evidence of cocaine-related coronary atherosclerosis in young patients with myocardial infarction. J Am Coll Cardiol. 2006 May 16;47(10):2120-2.
Ma I, Genet T, Clementy N, Bisson A, Herbert J, Semaan C, Bouteau J, Angoulvant D, Ivanes F, Fauchier L. Outcomes in patients with acute myocardial infarction and history of illicit drug use: a French nationwide analysis. Eur Heart J Acute Cardiovasc Care. 2021 Dec 6;10(9):1027-1037.
García-Olea A, Elorriaga A, Arregui A, Mendoza P, Andrés A, Sáez R. Premature acute myocardial infarction with ST segment elevation: a cohort study in the 2012-2022 decade. Arch Cardiol Mex. 2023;93(4):442-450. English.
Gresnigt FMJ, Hulshof M, Franssen EJF, Vanhommerig JW, de Lange DW, Riezebos RK. Recreational drug use among young, hospitalized patients with acute coronary syndrome: A retrospective study. Toxicol Rep. 2022 Nov 8;9:1993-1999.
Hollander JE, Hoffman RS. Cocaine-induced myocardial infarction: an analysis and review of the literature. J Emerg Med. 1992 Mar-Apr;10(2):169-77.
Minor RL Jr, Scott BD, Brown DD, Winniford MD. Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991 Nov 15;115(10):797-806.
Muntaner C, Kumor KM, Nagoshi C, Jaffe JH. Effects of nifedipine pretreatment on subjective and cardiovascular responses to intravenous cocaine in humans. Psychopharmacology (Berl). 1991;105(1):37-41.
Rowbotham MC, Hooker WD, Mendelson J, Jones RT. Cocaine-calcium channel antagonist interactions. Psychopharmacology (Berl). 1987;93(2):152-4. doi: 10.1007/BF00179925. PMID: 3122247.
Clinical outcomes after treatment of cocaine-induced chest pain with beta-blockers: a systematic review and meta-analysis. Lo KB, Virk HUH, Lakhter V, Ram P, Gongora C, Pressman G, Figueredo V. Am J Med. 2019;132:505–509.
Amoateng R, Ahmed I, Attah A, Hardman B. Teenager Presenting With Chest Pain and ST-Segment Changes on Electrocardiogram After SARS-CoV-2 Illness: Early Repolarization vs. Acute Pericarditis. Cureus. 2022 May 1;14(5):e24654.
Hollander JE, Wilson LD, Leo PJ, Shih RD. Complications from the use of thrombolytic agents in patients with cocaine associated chest pain. J Emerg Med. 1996 Nov-Dec;14(6):731-6.
Valgimigli M, Frigoli E, Heg D, Tijssen J, Jüni P, Vranckx P, Ozaki Y, Morice MC, Chevalier B, Onuma Y, Windecker S, Tonino PAL, Roffi M, Lesiak M, Mahfoud F, Bartunek J, Hildick-Smith D, Colombo A, Stanković G, Iñiguez A, Schultz C, Kornowski R, Ong PJL, Alasnag M, Rodriguez AE, Moschovitis A, Laanmets P, Donahue M, Leonardi S, Smits PC; MASTER DAPT Investigators. Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk. N Engl J Med. 2021 Oct 28;385(18):1643-1655.
Urban P, Meredith IT, Abizaid A, Pocock SJ, Carrié D, Naber C, Lipiecki J, Richardt G, Iñiguez A, Brunel P, Valdes-Chavarri M, Garot P, Talwar S, Berland J, Abdellaoui M, Eberli F, Oldroyd K, Zambahari R, Gregson J, Greene S, Stoll HP, Morice MC; LEADERS FREE Investigators. Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk. N Engl J Med. 2015 Nov 19;373(21):2038-47.
Mukherjee, D, Lange, R. Management of Cocaine-Associated Non–ST-Segment Elevation Myocardial Infarction: Is an Invasive Approach Beneficial?∗ . J Am Coll Cardiol Intv. 2021 Mar, 14 (6) 637–638
Appelboom T. La consommation de la coca dans l'Histoire [Consumption of coca in history]. Verh K Acad Geneeskd Belg. 1991;53(5):497-505.
Ruetsch YA, Böni T, Borgeat A. From cocaine to ropivacaine: the history of local anesthetic drugs. Curr Top Med Chem. 2001 Aug;1(3):175-82.
Drake LR, Scott PJH. DARK Classics in Chemical Neuroscience: Cocaine. ACS Chem Neurosci. 2018 Oct 17;9(10):2358-2372.
Grzybowski A. Historia kokainy w medycynie i jej znaczenie dla odkrycia róznych form znieczulenia [The history of cocaine in medicine and its importance to the discovery of the different forms of anaesthesia]. Klin Oczna. 2007;109(1-3):101-5.
Ryan SA. Cocaine Use in Adolescents and Young Adults. Pediatr Clin North Am. 2019 Dec;66(6):1135-1147.
Johnston L.D., Miech R.A., O’Malley P.M., et al: Monitoring the future national survey results on drug use: 1975-2017: overview, key findings on adolescent drug use. Ann Arbor (MI): Institute for Social Research, The University of Michigan, 2018.
Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report
Canadian Drug Summary: Cocaine (2022); Canadian Centre on Substance Use and Addiction.
Cocaine – the current situation in Europe; European Drug Report 2023.
Drug market trends; United Nations Office on Drugs and Crime.
Quinceavo estudio de drogas en la población general, SENDA.
Ritz MC, Cone EJ, Kuhar MJ. Cocaine inhibition of ligand binding at dopamine, norepinephrine and serotonin transporters: a structure-activity study. Life Sci. 1990;46(9):635-45.
Zhu F, Liu L, Li J, Liu B, Wang Q, Jiao R, Xu Y, Wang L, Sun S, Sun X, Younus M, Wang C, Hokfelt T, Zhang B, Gu H, Xu ZD, Zhou Z. Cocaine increases quantal norepinephrine secretion through NET-dependent PKC activation in locus coeruleus neurons. Cell Rep. 2022 Aug 16;40(7):111199.
Haas C, Karila L, Lowenstein W. Addiction a la cocaïne et au "crack": un problème de santé publique qui s'aggrave [Cocaine and crack addiction: a growing public health problem]. Bull Acad Natl Med. 2009 Apr;193(4):947-62; discussion 962-3.
Pradhan L, Mondal D, Chandra S, Ali M, Agrawal KC. Molecular analysis of cocaine-induced endothelial dysfunction: role of endothelin-1 and nitric oxide. Cardiovasc Toxicol. 2008 Dec;8(4):161-71.
Peruch M, Giacomello E, Radaelli D, Concato M, Addobbati R, Fluca AL, Aleksova A, D'Errico S. Subcellular Effectors of Cocaine Cardiotoxicity: All Roads Lead to Mitochondria-A Systematic Review of the Literature. Int J Mol Sci. 2023 Sep 25;24(19):14517.
Boess F, Ndikum-Moffor FM, Boelsterli UA, Roberts SM. Effects of cocaine and its oxidative metabolites on mitochondrial respiration and generation of reactive oxygen species. Biochem Pharmacol. 2000 Sep 1;60(5):615-23. doi: 10.1016/s0006-2952(00)00355-5. PMID: 10927019.
Havakuk O, Rezkalla SH, Kloner RA. The Cardiovascular Effects of Cocaine. J Am Coll Cardiol. 2017 Jul 4;70(1):101-113.
Hantson P. Mechanisms of toxic cardiomyopathy. Clin Toxicol (Phila). 2019 Jan;57(1):1-9.
Maceira AM, Guardiola S, Ripoll C, Cosin-Sales J, Belloch V, Salazar J. Detection of subclinical myocardial dysfunction in cocaine addicts with feature tracking cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2020 Sep 28;22(1):70.
Maceira AM, Ripoll C, Cosin-Sales J, Igual B, Gavilan M, Salazar J, Belloch V, Pennell DJ. Long term effects of cocaine on the heart assessed by cardiovascular magnetic resonance at 3T. J Cardiovasc Magn Reson. 2014 Apr 23;16(1):26.
Nash E, Roberts DM, Jamshidi N. Reverse Takotsubo Cardiomyopathy Precipitated by Chronic Cocaine and Cannabis Use. Cardiovasc Toxicol. 2021 Dec;21(12):1012-1018.
Lai H, Bluemke DA, Fishman EK, Gerstenblith G, Celentano DD, Treisman G, Foster P, Mandler R, Khalsa J, Chen S, Bhatia S, Kolossváry M, Lai S. High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis. J Addict Med. 2023 Mar-Apr 01;17(2):147-154.
Wang J, Patel PS, Andhavarapu S, Bzihlyanskaya V, Friedman E, Jeyaraju M, Palmer J, Raffman A, Pourmand A, Tran QK. Prevalence of myocardial infarction among patients with chest pain and cocaine use: A systematic review and meta-analysis. Am J Emerg Med. 2021.
Hollander JE, Hoffman RS, Gennis P, Fairweather P, DiSano MJ, Schumb DA, Feldman JA, Fish SS, Dyer S, Wax P, Whelan C, Schwartzwald E. Prospective multicenter evaluation of cocaine-associated chest pain. Cocaine Associated Chest Pain (COCHPA) Study Group. Acad Emerg Med. 1994; 1: 330–339.
Pergolizzi JV Jr, Magnusson P, LeQuang JAK, Breve F, Varrassi G. Cocaine and Cardiotoxicity: A Literature Review. Cureus. 2021 Apr 20;13(4):e14594.
Patrizi, R, Pasceri, V, Sciahbasi, A. et al. Evidence of Cocaine-Related Coronary Atherosclerosis in Young Patients With Myocardial Infarction. J Am Coll Cardiol. 2006 May, 47 (10) 2120–2122.
Patrizi R, Pasceri V, Sciahbasi A, Summaria F, Rosano GM, Lioy E. Evidence of cocaine-related coronary atherosclerosis in young patients with myocardial infarction. J Am Coll Cardiol. 2006 May 16;47(10):2120-2.
Ma I, Genet T, Clementy N, Bisson A, Herbert J, Semaan C, Bouteau J, Angoulvant D, Ivanes F, Fauchier L. Outcomes in patients with acute myocardial infarction and history of illicit drug use: a French nationwide analysis. Eur Heart J Acute Cardiovasc Care. 2021 Dec 6;10(9):1027-1037.
García-Olea A, Elorriaga A, Arregui A, Mendoza P, Andrés A, Sáez R. Premature acute myocardial infarction with ST segment elevation: a cohort study in the 2012-2022 decade. Arch Cardiol Mex. 2023;93(4):442-450. English.
Gresnigt FMJ, Hulshof M, Franssen EJF, Vanhommerig JW, de Lange DW, Riezebos RK. Recreational drug use among young, hospitalized patients with acute coronary syndrome: A retrospective study. Toxicol Rep. 2022 Nov 8;9:1993-1999.
Hollander JE, Hoffman RS. Cocaine-induced myocardial infarction: an analysis and review of the literature. J Emerg Med. 1992 Mar-Apr;10(2):169-77.
Minor RL Jr, Scott BD, Brown DD, Winniford MD. Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991 Nov 15;115(10):797-806.
Muntaner C, Kumor KM, Nagoshi C, Jaffe JH. Effects of nifedipine pretreatment on subjective and cardiovascular responses to intravenous cocaine in humans. Psychopharmacology (Berl). 1991;105(1):37-41.
Rowbotham MC, Hooker WD, Mendelson J, Jones RT. Cocaine-calcium channel antagonist interactions. Psychopharmacology (Berl). 1987;93(2):152-4. doi: 10.1007/BF00179925. PMID: 3122247.
Clinical outcomes after treatment of cocaine-induced chest pain with beta-blockers: a systematic review and meta-analysis. Lo KB, Virk HUH, Lakhter V, Ram P, Gongora C, Pressman G, Figueredo V. Am J Med. 2019;132:505–509.
Amoateng R, Ahmed I, Attah A, Hardman B. Teenager Presenting With Chest Pain and ST-Segment Changes on Electrocardiogram After SARS-CoV-2 Illness: Early Repolarization vs. Acute Pericarditis. Cureus. 2022 May 1;14(5):e24654.
Hollander JE, Wilson LD, Leo PJ, Shih RD. Complications from the use of thrombolytic agents in patients with cocaine associated chest pain. J Emerg Med. 1996 Nov-Dec;14(6):731-6.
Valgimigli M, Frigoli E, Heg D, Tijssen J, Jüni P, Vranckx P, Ozaki Y, Morice MC, Chevalier B, Onuma Y, Windecker S, Tonino PAL, Roffi M, Lesiak M, Mahfoud F, Bartunek J, Hildick-Smith D, Colombo A, Stanković G, Iñiguez A, Schultz C, Kornowski R, Ong PJL, Alasnag M, Rodriguez AE, Moschovitis A, Laanmets P, Donahue M, Leonardi S, Smits PC; MASTER DAPT Investigators. Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk. N Engl J Med. 2021 Oct 28;385(18):1643-1655.
Urban P, Meredith IT, Abizaid A, Pocock SJ, Carrié D, Naber C, Lipiecki J, Richardt G, Iñiguez A, Brunel P, Valdes-Chavarri M, Garot P, Talwar S, Berland J, Abdellaoui M, Eberli F, Oldroyd K, Zambahari R, Gregson J, Greene S, Stoll HP, Morice MC; LEADERS FREE Investigators. Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk. N Engl J Med. 2015 Nov 19;373(21):2038-47.
Mukherjee, D, Lange, R. Management of Cocaine-Associated Non–ST-Segment Elevation Myocardial Infarction: Is an Invasive Approach Beneficial?∗ . J Am Coll Cardiol Intv. 2021 Mar, 14 (6) 637–638