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Cocaine-associated chest pain: one-year follow-up

J E Hollander1, R S Hoffman, P Gennis

  • 1Department of Emergency Medicine, University Hospital, State University of New York, Stony Brook 11794-7400, USA.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|March 1, 1995
PubMed

Insights

Patients with chest pain from cocaine use have a low one-year risk of death or heart attack (myocardial infarction, MI). Continued cocaine use is common and linked to recurrent chest pain, underscoring the need for cessation interventions.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Toxicology

Background:

  • Cocaine use is a significant cause of chest pain presentations to emergency departments.
  • The long-term cardiac outcomes for patients experiencing cocaine-associated chest pain are not well-established.

Purpose of the Study:

  • To assess one-year mortality and myocardial infarction (MI) rates after hospital discharge or ED release in patients with cocaine-associated chest pain.

Main Methods:

  • A prospective, observational study followed 203 patients presenting with cocaine-associated chest pain.
  • Patients were monitored for one year to determine survival and nonfatal MI incidence.

Main Results:

  • One-year actuarial survival was 98%, with no deaths attributed to MI.
  • Nonfatal myocardial infarction (MI) occurred in only 1% of patients.
  • Sixty percent of patients continued cocaine use, associated with recurrent chest pain; no MI or death occurred in those who ceased use.

Conclusions:

  • Patients with cocaine-associated chest pain have a low subsequent risk of MI and death if MI is ruled out and pain is not recurrent.
  • Urgent cardiac evaluations may not be necessary for all patients in this cohort.
  • Emphasis on cocaine cessation is crucial for intervention strategies.
Abstract

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