コカインによる心筋梗塞の誘発
M A Mittleman1, D Mintzer, M Maclure
1Institute for Prevention of Cardiovascular Disease, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. mmittlem@hsph.harvard.edu
Circulation
|June 3, 1999
まとめ
コカインの使用は,急性心筋梗塞 (心臓発作) の直接リスクを23.7倍に大幅に高めます. このリスクは実質的ですが,一時的なもので,コカインを強調しています.
科学分野:
- 心臓病学 心臓病学
- 毒理学 毒理学 毒理学
- 公衆衛生は公衆衛生である.
背景:
- コカインは急性心筋梗塞 (AMI) のトリガーとして知られており,事前に冠動脈疾患がない人でも同様です.
- コカイン使用後のAMIの直接的なリスク増加の正確な大きさは,十分に確立されていません.
研究 の 目的:
- コカイン使用に関連した急性心筋梗塞 (AMI) の直接的なリスクを定量化するために.
- コカインを使用し,AMIを経験する個人の特徴を調査する.
主な方法:
- ケース・クロスオーバー・スタディ・デザインを用いて,AMI患者の3946人をインタビューした.
- 参加者は,症状の発症の1時間前にコカインを使用したと報告しました.
- セルフマッチングされた対照群のデータは,AMI発症前のコカイン使用頻度と予想される頻度とを比較した.
主要な成果:
- 3946人の患者のうち9人 (1%) は,AMI発症から60分以内にコカインを使用したと報告しました.
- コカイン使用者は,より若い,男性,現在の喫煙者,およびマイノリティーグループからの可能性が高くなりました.
- コカインの使用は,60分以内にAMI発症のリスクが23.7倍増加した (95%CI 8.5〜66.3) と関連していました.
結論:
- コカインの使用は,特にリスクが低い個体において,AMIリスクの大きく,急激かつ一時的な増加を引き起こします.
- コカインの病理生理学的効果を調査することで,他のストレス要因によって引き起こされるAMIのメカニズムを明らかにすることができます.
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