RESUMO
Increased mean platelet volume (MPV) is a marker of platelet activation. Platelet activation with cocaine use is not well studied. We wanted to investigate MPV levels in patients with cocaine-associated chest pain (CACP) as a marker of platelet activation. Retrospectively, MPV of 82 consecutive patients with CACP (group 1) with positive urine drug screen (UDS), without acute myocardial infarction (AMI) (group 1A) and with AMI with elevated troponin (group 1B), were included in the study. The control group (group 2) consisted of 89 consecutive patients admitted during the same time period with acute chest pain (ACP) who had negative UDS and negative cardiac markers with a normal cardiac stress test or normal coronary angiogram. Analysis showed no statistically significant difference of MPV between group 1, 8.46 ± 1.06 fL, versus group 2, 8.7 ± 1.07 fL; p = 0.142; and between group 1A, 8.46 ± 1.05 fL, and group 1B, 8.46 ± 1.09 fL; p = 0.983. By multiple linear regression analysis, MPV was not influenced by cocaine abuse (R = 0.269, R (2) = 0.072, adjusted R (2) = -0.009, p = 0.562). MPV is not elevated in patients with cocaine use even when they had AMI. Further studies may be necessary to investigate the role of platelet activation in patients with cocaine use and chest pain.
Assuntos
Falso Aneurisma/diagnóstico , Angiografia Coronária , Ecocardiografia Doppler em Cores , Aneurisma Cardíaco/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Valor Preditivo dos Testes , Fatores de TempoRESUMO
The role of homocysteine as a risk factor for cardiovascular disease remains controversial because positive reports from case-control studies may be the consequence of reverse causality bias, and positive and negative results have been reported in cohort studies. This is a meta-analysis of published cohort studies. An average relative risk (ARR) was calculated using fixed and random effect models. The likelihood of publication and selection bias, and the impact of each study on the ARR were also evaluated. Fourteen eligible studies were retrieved. We found no evidence of publication bias (P =.62) nor heterogeneity (P =.56). The ARRs from a fixed effect model were 1.49 (95% CI: 1.31-1.70) for cardiac events, and 1.37 (95% CI: 0.99- 1.99) for ischemic stroke. Duration of follow up and age did not significantly change the ARRs. Hyperhomocysteinemia moderately increases the risk of a first cardiovascular event, regardless of age and follow-up duration.
