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Cocaine use is associated with an increased risk of stent thrombosis after percutaneous coronary intervention.

Abstract：

BACKGROUND:The treatment of cocaine-related acute coronary syndromes presents unique challenges. Although percutaneous coronary intervention in cocaine abusers appears to be safe in the short term, longer-term outcomes have not been reported. We postulated that cocaine use would be associated with increased risk for stent thrombosis. METHODS:We report 30-day and 9-month clinical outcomes including stent thrombosis, myocardial infarction, repeat revascularization, and death in 71 cocaine abusers who underwent percutaneous coronary intervention at our institution (66 of whom received a stent) compared with 3216 control patients. Propensity score-matched analysis was performed to control for statistical bias present in nonrandomized study populations. RESULTS:Stent thrombosis occurred in 5 (7.6%) of the 66 stented cocaine abusers during the 9-month follow-up period compared to a 0.6% rate of stent thrombosis in the control database, a highly statistically significant difference (P < .001). In the propensity analysis, stent thrombosis occurred in 4 stented cocaine abusers and 0 of 70 matched controls (6.2% vs 0%; P = .04) throughout the 9-month follow-up period. There was no significant difference in overall rates of myocardial infarction, death, or repeat revascularization at 9 months. CONCLUSIONS:Because of the increased risk of stent thrombosis, consideration should be given to a more conservative approach in cocaine abusers who present with acute coronary syndromes.

journal_name

Am Heart J

journal_title

American heart journal

authors

McKee SA,Applegate RJ,Hoyle JR,Sacrinty MT,Kutcher MA,Sane DC

doi

10.1016/j.ahj.2007.04.004

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

159-64

issue

1

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(07)00282-7

journal_volume

154

pub_type

杂志文章

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