Síndrome coronario agudo y cocaína / Acute coronary syndrome and cocaine

Fundamento y objetivo: La cocaína está directamente relacionada con la aparición de síndrome coronario agudo (SCA). Analizamos las características diferenciales de los consumidores que presentan un SCA en nuestro medio. Material y métodos: Estudio retrospectivo de 914 pacientes con SCA que ingresaron de forma consecutiva en nuestro hospital. Resultados: Un total de 34 pacientes refirieron ser consumidores (3,7%, intervalo de confianza del 95% [IC del 95%], 2,7 5,2), con edad media (desviación estándar [DE]) de 40,1 (9,1) años, significativamente menor que en los no consumidores (63,6 [12,15] años; p<0,001). La prevalencia aumenta progresivamente en los grupos de menor edad. La mayoría son varones (82,4%), con mayor consumo de tabaco (el 88,2 frente al 34,2%; p<0,001) y de otras drogas ilegales (el 35,3 frente al 0,9%; p<0,001). Por el contrario, tienen con menos frecuencia hipertensión (el 26,5 frente al 60,5%; p<0,001) o diabetes (el 11,7 frente al 39,8%; p<0,001). Presentan enfermedad monovaso el 44,1% y coronariografía sin lesiones significativas el 20,6% de los casos. Conclusiones: El enfermo con SCA y consumidor de cocaína es generalmente un varón joven, que con frecuencia consume otras drogas y con una menor prevalencia de factores de riesgo clásico, datos a tener en cuenta a la hora de tomar medidas preventivas y terapéuticas (AU)

Background and objectives: Cocaine is directly related to the occurrence of acute coronary syndromes (ACS). We analyzed the differential characteristics of consumers who suffer an ACS in our environment. Material and methods: A retrospective study of 914 patients with ACS who entered consecutively to our hospital. Results: Thirty four patients were consumers (3.7%, CI95%: 2.7 5.2), with an average age of 40.1±9.1 years, significantly lower than non-consumers (63.6±12.15 years, P<.001). The prevalence increased progressively in younger groups. Most were men (82.4%), with higher consumption of tobacco (88.2% vs. 34.2%, P<.001) and other illegal drugs (35.3% vs 0.9%, P<.001). By contrast, they had less frequently hypertension (26.5 vs. 60.5%, P<.001) or diabetes (11.7 vs. 39.8%, P<.001). There was single vessel disease in 44.1%, and a coronary angiography without significant lesions in 20.6% cases. Conclusions: The typical patient with ACS who consumes cocaine is usually a young man, who often takes other drugs and with a lower prevalence of classic risk factors. These data have to be taken into account when considering preventive and therapeutic manoeuvres (AU)

[Acute coronary syndrome and cocaine]. / Síndrome coronario agudo y cocaína.

BACKGROUND AND OBJECTIVES: Cocaine is directly related to the occurrence of acute coronary syndromes (ACS). We analyzed the differential characteristics of consumers who suffer an ACS in our environment. MATERIAL AND METHODS: A retrospective study of 914 patients with ACS who entered consecutively to our hospital. RESULTS: Thirty four patients were consumers (3.7%, CI95%: 2.7-5.2), with an average age of 40.1+/-9.1 years, significantly lower than non-consumers (63.6+/-12.15 years, P<.001). The prevalence increased progressively in younger groups. Most were men (82.4%), with higher consumption of tobacco (88.2% vs. 34.2%, P<.001) and other illegal drugs (35.3% vs 0.9%, P<.001). By contrast, they had less frequently hypertension (26.5 vs. 60.5%, P<.001) or diabetes (11.7 vs. 39.8%, P<.001). There was single vessel disease in 44.1%, and a coronary angiography without significant lesions in 20.6% cases. CONCLUSIONS: The typical patient with ACS who consumes cocaine is usually a young man, who often takes other drugs and with a lower prevalence of classic risk factors. These data have to be taken into account when considering preventive and therapeutic manoeuvres.