This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Qureshi, A. I. Articles by Hopkins, L. N. Search for Related Content PubMed PubMed Citation Articles by Qureshi, A. I. Articles by Hopkins, L. N. Related Collections Cerebrovascular disease/stroke Risk Factors Acute myocardial infarction Epidemiology

(Circulation. 2001;103:502.)
© 2001 American Heart Association, Inc.

Clinical Investigation and Reports

Cocaine Use and the Likelihood of Nonfatal Myocardial Infarction and Stroke

Data From the Third National Health and Nutrition Examination Survey

Adnan I. Qureshi, MD; M. Fareed K. Suri, MD; Lee R. Guterman, PhD, MD; L. Nelson Hopkins, MD

From the Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.

Correspondence to Adnan I. Qureshi, MD, Department of Neurosurgery, SUNYAB, 3 Gates Circle, Buffalo, NY 14209-1194. E-mail aiqureshi{at}hotmail.com

Background—Numerous case series have implicated cocaine use as a cause of both myocardial infarction (MI) and stroke on the basis of the temporal relationship between drug use and event onset. Increasing cocaine use in the US population, especially in younger individuals, mandates a more extensive investigation of this relationship.

Methods and Results—We determined the association of cocaine use with self-reported physician diagnosis of MI or stroke in a nationally representative sample of 10 085 US adults aged 18 to 45 years who participated in the Third National Health and Nutrition Examination Survey. A total of 46 nonfatal MIs and 33 nonfatal strokes were reported. After adjusting for differences in age, sex, race/ethnicity, education, hypertension, diabetes mellitus, cholesterol level, body mass index, and cigarette smoking, persons who reported frequent lifetime cocaine use had a significantly higher likelihood of nonfatal MI than nonusers (odds ratio, 6.9; 95% confidence interval, 1.3 to 58) but not stroke. In this age group, the population-attributable risk percent of frequent cocaine for nonfatal MI was estimated as 25%.

Conclusion—Regular cocaine use was associated with an increased likelihood of MI in younger patients. Approximately 1 of every 4 nonfatal MIs in persons aged 18 to 45 years was attributable to frequent cocaine use in this survey. Behavior modification by public awareness and education may reduce the cardiovascular morbidity associated with cocaine use.

Key Words: cocaine • stroke • myocardial infarction • risk factors

This article has been cited by other articles:

				S. H. Rezkalla and R. A. Kloner Cocaine-Induced Acute Myocardial Infarction Clin. Med. Res., October 1, 2007; 5(3): 172 - 176. [Abstract] [Full Text] [PDF]

				D. M Wood, D. Hill, A. Gunasekera, S. L Greene, A. L Jones, and P. I Dargan Is cocaine use recognised as a risk factor for acute coronary syndrome by doctors in the UK? Postgrad. Med. J., May 1, 2007; 83(979): 325 - 328. [Abstract] [Full Text] [PDF]

				A. N. Westover, S. McBride, and R. W. Haley Stroke in Young Adults Who Abuse Amphetamines or Cocaine: A Population-Based Study of Hospitalized Patients Arch Gen Psychiatry, April 1, 2007; 64(4): 495 - 502. [Abstract] [Full Text] [PDF]

				R. Jones, H. Marcer, and S. Haig What paediatricians should know about young people and drugs in the UK Arch. Dis. Child. Ed. Pract., October 1, 2006; 91(3): ep81 - ep86. [Full Text] [PDF]

				R. Patrizi, V. Pasceri, A. Sciahbasi, F. Summaria, G. M.C. Rosano, and E. Lioy Evidence of Cocaine-Related Coronary Atherosclerosis in Young Patients With Myocardial Infarction J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2120 - 2122. [Full Text] [PDF]

				M. W. Ketterer, G. Mahr, J. J. Cao, M. Hudson, S. Smith, and W. Knysz What's "Unstable" in Unstable Angina? Psychosomatics, June 1, 2004; 45(3): 185 - 196. [Abstract] [Full Text] [PDF]

				K. B. Keller and L. Lemberg The Cocaine-Abused Heart Am. J. Crit. Care., November 1, 2003; 12(6): 562 - 566. [Full Text] [PDF]

				Minerva BMJ, October 6, 2003; 327(7418): E29 - 29. [Full Text] [PDF]

				J. E. Weber, F. S. Shofer, G. L. Larkin, A. S. Kalaria, and J. E. Hollander Validation of a Brief Observation Period for Patients with Cocaine-Associated Chest Pain N. Engl. J. Med., February 6, 2003; 348(6): 510 - 517. [Abstract] [Full Text] [PDF]

				B. M. Curtis and J. H. O'Keefe Jr Autonomic Tone as a Cardiovascular Risk Factor: The Dangers of Chronic Fight or Flight Mayo Clin. Proc., January 1, 2002; 77(1): 45 - 54. [Abstract] [PDF]

				A Ghuran, L R van der Wieken, and J Nolan Cardiovascular complications of recreational drugs BMJ, September 1, 2001; 323(7311): 464 - 466. [Full Text] [PDF]

				Cocaine Use Increases Risk of Acute MI Sixfold Journal Watch Emergency Medicine, April 2, 2001; 2001(402): 10 - 10. [Full Text]