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(Circulation. 2008;117:1897-1907.)
© 2008 American Heart Association, Inc.

AHA Scientific Statement

Management of Cocaine-Associated Chest Pain and Myocardial Infarction

A Scientific Statement From the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology

James McCord, MD; Hani Jneid, MD; Judd E. Hollander, MD; James A. de Lemos, MD; Bojan Cercek, MD, FAHA; Priscilla Hsue, MD; W. Brian Gibler, MD; E. Magnus Ohman, MD; Barbara Drew, RN, PhD, FAHA; George Philippides, MD; L. Kristin Newby, MD, MHS

Key Words: AHA Scientific Statement • cocaine • substance-related disorders • myocardial infarction

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The goals of the present article are to provide a critical review of the literature on cocaine-associated chest pain and myocardial infarction (MI) and to give guidance for diagnostic and therapeutic interventions. Classification of recommendations and levels of evidence are expressed in the American College of Cardiology/American Heart Association (ACC/AHA) format as follows:

• Class I: Conditions for which there is evidence for and/or general agreement that the procedure or treatment is beneficial, useful, and effective.
  
• Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment.
  •    Class IIa: Weight of evidence/opinion is in favor of usefulness/efficacy.
    
  •    Class IIb: Usefulness/efficacy is less well established by evidence/opinion.
    
  
  
• Class III: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful.
  
• Level of Evidence A: Data derived from multiple randomized clinical trials.
  
• Level of Evidence B: Data derived from a single randomized trial or nonrandomized studies.
  
• Level of Evidence C: Only consensus opinion of experts, case studies, or standard of care.
  

	Methods

 
The Writing Committee conducted a comprehensive search of the medical literature concerning cocaine-associated chest pain and MI. The literature search included English-language publications on humans and animals from 1960 to 2007. In addition to broad-based searching concerning cocaine, specific targeted searches were performed on cocaine and the following topics: MI, chest pain, emergency department (ED), aspirin, nitroglycerin, calcium channel blocker, . . . [Full Text of this Article]

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