McLaurin M, Apple F S, Henry T D, Sharkey S W
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA.
Ann Clin Biochem. 1996 May;33 ( Pt 3):183-6. doi: 10.1177/000456329603300301.
Patients with cocaine-related chest pain with electrocardiographic (ECG) abnormalities are often admitted to rule out acute myocardial infarction (AMI). Cardiac troponin I and T should be superior to measurement of creatine kinase (CK)-MB for detecting cardiac injury in patients with coexisting skeletal muscle injury. We prospectively evaluated 19 consecutive patients with acute chest pain related to cocaine use who were hospitalized to rule out AMI. The admission ECG was abnormal in 16 of 19 patients. Total CK and CK-MB were elevated during the hospital course in 14 and 3 patients, respectively. Cardiac troponin I and cardiac troponin T levels were within normal limits in all patients demonstrating that recent myocardial injury did not occur. Clinically, no patient had an AMI. Cocaine-induced thoracic skeletal muscle injury or transient cocaine-induced coronary vasospasm should be considered as alternative sources of chest pain in these patients.
伴有心电图（ECG）异常的可卡因相关性胸痛患者常被收治以排除急性心肌梗死（AMI）。在存在骨骼肌损伤的患者中，心肌肌钙蛋白I和T在检测心脏损伤方面应优于肌酸激酶（CK）-MB测定。我们前瞻性评估了19例因使用可卡因导致急性胸痛而住院以排除AMI的连续患者。19例患者中有16例入院时心电图异常。住院期间，总CK和CK-MB分别在14例和3例患者中升高。所有患者的心肌肌钙蛋白I和心肌肌钙蛋白T水平均在正常范围内，表明近期未发生心肌损伤。临床上，无患者发生AMI。在这些患者中，应考虑可卡因诱导的胸部骨骼肌损伤或短暂性可卡因诱导的冠状动脉痉挛作为胸痛的其他原因。
