Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Research Institute Germans Trias i Pujol, Badalona, Spain; CIBERCV, Madrid, Spain.
Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Research Institute Germans Trias i Pujol, Badalona, Spain.
Int J Cardiol. 2019 May 15;283:23-27. doi: 10.1016/j.ijcard.2018.12.026. Epub 2018 Dec 10.
The use of cocaine as a recreational drug has increased over recent years. In this study, we aimed to analyze the prevalence, and in-hospital and long-term outcomes of acute coronary syndrome (ACS) associated with cocaine consumption (ACS-ACC).
A prospective observational registry of young patients hospitalised with ACS from 2001 through 2015, we analysed ACS-ACC temporal trends, clinical characteristics, and major adverse cardiovascular events (MACE) during long-term follow-up.
There were 8153 admissions with ACS, of whom 864 patients were ≤50-years-old; 59 patients (6.8%) presented with ACS-ACC. The prevalence of patients with a history of cocaine consumption increased to maximum of 18% in 2008 with no variations thereafter (r = 0.74, p < 0.001). The ACS-ACC incidence increased over time from 5% to 9% (r = 0.25, p = 0.07). Compared to patients with ACS not associated with cocaine consumption, the ACS-ACC exhibited a higher incidence of in-hospital ventricular tachycardia (16.9% vs 4.7%, p < 0.001) and trends to in-hospital mortality (3.4% vs 1.0%, p = 0.097); during a median follow-up of 5.6 years, ACS-ACC had higher risk of MACE (HR 1.83; 95% CI 1.04-3.25, p = 0.038), higher risk of myocardial infarction (HR 2.39, 95% CI 1.02-5.60, p = 0.045), and higher risk of cardiovascular mortality (HR 6.26; 95% CI 1.67-23.43, p = 0.006).
Young patients with ACS-ACC carry a high risk of short and long-term major adverse cardiovascular events. Over the 15-year study period, we observed an increasing prevalence of this entity. This trend and its outcomes underscore the need for increased awareness and improved management strategies.
近年来，可卡因作为一种娱乐性药物的使用有所增加。在这项研究中，我们旨在分析与可卡因使用相关的急性冠状动脉综合征（ACS-ACC）的患病率、院内和长期结局。
这是一项针对 2001 年至 2015 年期间因 ACS 住院的年轻患者的前瞻性观察性登记研究，我们分析了 ACS-ACC 的时间趋势、临床特征以及长期随访期间的主要不良心血管事件（MACE）。
共有 8153 例 ACS 患者入院，其中 864 例患者年龄≤50 岁；59 例（6.8%）患者出现 ACS-ACC。有可卡因使用史的患者比例最高增加至 2008 年的 18%，此后无变化（r=0.74，p<0.001）。ACS-ACC 的发生率随时间增加，从 5%增加至 9%（r=0.25，p=0.07）。与无可卡因使用相关的 ACS 患者相比，ACS-ACC 的院内室性心动过速发生率更高（16.9% vs. 4.7%，p<0.001），院内死亡率有升高趋势（3.4% vs. 1.0%，p=0.097）；在中位随访 5.6 年期间，ACS-ACC 的 MACE 风险更高（HR 1.83；95% CI 1.04-3.25，p=0.038）、心肌梗死风险更高（HR 2.39；95% CI 1.02-5.60，p=0.045）、心血管死亡风险更高（HR 6.26；95% CI 1.67-23.43，p=0.006）。
ACS-ACC 的年轻患者有发生短期和长期主要不良心血管事件的高风险。在 15 年的研究期间，我们观察到这种情况的患病率呈上升趋势。这种趋势及其结果强调了需要提高认识并改进管理策略。
