The Journal of Emergency Medicine
Volume 29, Issue 2 , Pages 173-178 , August 2005

The cardiovascular effects of cocaine

  • Charles N. Pozner, MD

      Affiliations

    • Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard University, Boston, Massachusetts
    • Corresponding Author InformationReprint Address: Charles N. Pozner, md, Department of Emergency Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115
  • ,
  • Michael Levine, MD

      Affiliations

    • Harvard-Affiliated Emergency Medicine Residency, Brigham and Women’s Hospital/Massachusetts General Hospital, Boston, Massachusetts
  • ,
  • Richard Zane, MD

      Affiliations

    • Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard University, Boston, Massachusetts

Received 10 October 2003 ,Revised 25 November 2004 ,Accepted 26 January 2005.

References 

  1. Kosten TR , Hollister LE . Drugs of abuse . In:  Katzung BG editors. Basic and clinical pharmacology . New York: Lange Medical Books/McGraw Hill; 2001;p. 532–547
  2. Colliver JD , Kopstein AN . Trends in cocaine abuse reflected in emergency room episodes reported to DAWN (Drug Abuse Warning Network) . Public Health Rep . 1991;106:59–68
  3. Leikin JB , Morris RW , Warren M , et al.   Trends in a decade of drug abuse presentations to an inner city ED . Am J Emerg Med . 2001;19:37–39
  4. The Drug Abuse Warning Network. Table 2.2.0. Available at. http://dawninfo.samhsa.gov/pubs_94_02/pickatable/2002/2.2.0.xls. Accessed September 13, 2003.
  5. Office of Applied Studies . Year-end 1999 emergency department data from the Drug Abuse Warning Network . Rockville, MD: Substance Abuse and Mental Health Services Administration; 2000; (DHHS publication number [SMA] 00-3462).
  6. Rouse BA . Trends in cocaine use in the general population . In:  Schober S ,  Schade C editor. National Institute on Drug Abuse Research monograph series. The epidemiology of cocaine use and abuse . Rockville, MD: US Department of Health and Human Services; 1991;p. 110; (DHHS pub #91-1787)
  7. Lange RA , Hillis LD . Cardiovascular complications of cocaine use . N Engl J Med . 2001;345:351–358
  8. Massachusetts Poison Control System. Cocaine poisoning (an update) . Clin Toxicol Rev . 1995;17:1–3
  9. Benowitz NL . Clinical pharmacology and toxicology of cocaine . Pharmacol Toxicol . 1993;72:3–12
  10. Perez-Reyes M , Di Guiseppi S , Ondrusek G , et al.   Free base cocaine smoking . Clin Pharmacol Ther . 1982;32:459–465
  11. Ndikum-Moffor FM , Schoeb TR , Roberts SM . Liver toxicity from norcocaine nitroxide, an N-oxidative metabolite of cocaine . J Pharmacol Exp Ther . 1998;248:413–419
  12. Colliver JD , Kopstein AN . Trends in cocaine abuse reflected in emergency room episodes reported to DAWN, Drug Abuse Warning Network . Public Health Rep . 1991;106:59–68
  13. Albertson TE , Marelich GP , Tharratt RS . Cocaine . In:  Haddad LM ,  Shannon MW ,  Winchester JF editor. Clinical management of poisoning and drug overdose . 3rd edn.. Philadelphia: WB Saunders Company; 1998;p. 542–551
  14. Rose JS . Cocaethylene (a current understanding of the active metabolite of cocaine and ethanol) . Am J Emerg Med . 1994;12:489–490
  15. Perez-Reyes M , Jeffcoat AR , Myers M , et al.   Comparison in humans of the potency and pharmacokinetics of intravenously injected cocaethylene and cocaine . Psychopharmacology (Berl) . 1994;116:428–432
  16. Goldfrank LR , Hoffman RS . The cardiovascular effects of cocaine . Ann Emerg Med . 1991;20:165–175
  17. Brickner ME , Willard JE , Eichhorn EJ , et al.   Left ventricular hypertrophy associated with chronic cocaine abuse . Circulation . 1991;84:1130–1135
  18. Majid PA , Patel B , Kim HS , et al.   An angiographic and histologic study of cocaine-induced chest pain . Am J Cardiol . 1990;65:812–814
  19. Hollander JE . The management of cocaine-associated myocardial ischemia . N Engl J Med . 1995;333:1267–1272
  20. Mouhaffel AH , Madu EC , Satmary WA , et al.   Cardiovascular complications of cocaine . Chest . 1995;107:1426–1434
  21. Perrone J , Hollander JE , De Roos F . Cardiovascular risk factors and atherosclerosis in children and young adults . N Engl J Med . 1998;339:1083–1084
  22. Kloner RA , Hale S , Alker K , et al.   The effects of acute and chronic cocaine use on the heart . Circulation . 1992;85:407–419
  23. Kolodgie FD , Wilson PS , Mergner WJ , et al.   Cocaine-induced increase in the permeability function of human vascular endothelial cell monolayers . Exp Mol Pathol . 1999;66:109–122
  24. Schindler CW . Cocaine and cardiovascular toxicity . Addict Biol . 1996;1:31–47
  25. Fineschi V , Wetli CV , Di Paolo M , et al.   Myocardial necrosis and cocaine. A quantitative morphologic study in 26 cocaine associated deaths . Int J Legal Med . 1997;110:193–198
  26. Virmani R . Cocaine-associated cardiovascular disease (clinical and pathological aspects) . NIDA Res Monogr . 1991;108:220–229
  27. Perron AD , Gibbs M . Thoracic aortic dissection secondary to crack cocaine ingestion . Am J Emerg Med . 1997;15:507–509
  28. Das G . Cardiovascular effects of cocaine abuse . Int J Clin Pharmacol Ther Toxicol . 1993;31:521–528
  29. Neiman J , Haapaniemi HM , Hillbom M . Neurological complications of drug abuse (pathophysiological mechanisms) . Eur J Neurol . 2000;7:595–606
  30. Benowitz NL . Cocaine . In:  Olson KR editors. Poisoning and drug overdose . 3rd edn.. Stamford, CT: Appleton and Lange; 1999;p. 142–145
  31. Chambers HF , Morris DL , Tauber MG , et al.   Cocaine use and the risk for endocarditis in intravenous drug users . Ann Intern Med . 1987;106:833–836
  32. Rump AF , Theisohn M , Klaus W . The pathophysiology of cocaine cardiotoxicity . Forensic Sci Int . 1995;71:103–115
  33. Mo JT , Zhu LX , Sharma S , et al.   Cocaine inhibits human endothelial cell IL-8 production (the role of transforming growth factor beta) . Cell Immunol . 1997;181:38–43
  34. Brody SL , Slovis CM , Wrenn KD . Cocaine-related medical problems (consecutive series of 233 patients) . Am J Med . 1990;88:325–331
  35. Derlet RW , Albertson TE . Emergency department presentation of cocaine intoxication . Ann Emerg Med . 1989;18:182–186
  36. Goel P , Flaker GC . Cardiovascular complications of cocaine use . N Engl J Med . 2001;345:1575–1576
  37. Albrecht CA , Jafri A , Linville L , et al.   Cocaine-induced pneumopericardium . Circulation . 2000;102:2792–2794
  38. Seaman ME . Barotrauma related to inhalational drug abuse . J Emerg Med . 1990;8:141–149
  39. Uva JL . Spontaneous pneumothoraces, pneumomediastinum, pneumoperitoneum (consequences of smoking crack cocaine) . Pediatr Emerg Care . 1997;13:24–26
  40. Bauman JL , DiDomenico RJ . Cocaine-induced channelopathies (emerging evidence on the multiple mechanisms of sudden death) . J Cardiovasc Pharmacol Ther . 2002;7:195–202
  41. Kanani PM , Guse PA , Smith WM , et al.   Acute deleterious effects of cocaine on cardiac conduction, hemodynamics, and ventricular fibrillation threshold (effects of interaction with selective dopamine D1 antagonist SCH39166) . J Cardiovasc Pharmacol . 1998;32:42–48
  42. Hollander JE , Hoffman RS . Cocaine-induced myocardial infarction (an analysis and review of the literature) . J Emerg Med . 1992;10:169–177
  43. Weber JE , Chudnofsky CR , Boczar M , et al.   Cocaine-associated chest pain (how common is myocardial infarction?) . Acad Emerg Med . 2000;7:873–877
  44. Mittleman MA , Mintzer D , Maclure M , et al.   Triggering of myocardial infarction by cocaine . Circulation . 1999;99:2737–2741
  45. Hollander JE , Vignona L , Burstein J . Predictors of underlying coronary artery disease in cocaine associated myocardial infarction (a meta-analysis of case reports) . Vet Hum Toxicol . 1997;39:276–280
  46. Benzaquen BS , Cohen V , Eisenberg MJ . Effects of cocaine on coronary arteries . Am Heart J . 2001;142:402–410
  47. Wilbert-Lampen U , Seliger C , Zilker T , et al.   Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine (reversal by co-incubation with sigma-receptor antagonists) . Circulation . 1998;98:385–390
  48. Mo W , Singh AK , Arruda JA , et al.   Role of nitric oxide in cocaine-induced acute hypertension . Am J Hypertens . 1998;11:708–714
  49. Moliterno DJ , Willard JE , Lange RA , et al.   Coronary-artery vasoconstriction induced by cocaine, cigarette smoking, or both . N Engl J Med . 1994;330:454–459
  50. Inaba T , Stewart DJ , Kalow W . Metabolism of cocaine in man . Clin Pharmacol Ther . 1978;23:547–552
  51. Siegel AJ , Sholar MB , Mendelson JH , et al.   Cocaine-induced erythrocytosis and increase in von Willebrand factor (evidence for drug-related blood doping and prothrombotic effects) . Arch Intern Med . 1999;159:1925–1929
  52. Moliterno DJ , Lange RA , Gerard RD , et al.   Influence of intranasal cocaine on plasma constituents associated with endogenous throbosis and thrombolysis . Am J Med . 1994;96:492–496
  53. Heesch CM , Wilhelm CR , Ristich J , et al.   Cocaine activates platelet and increases the formation of circulating platelet containing microaggregates in humans . Heart . 2000;83:688–695
  54. Zhang L , Xiao Y , He J . Cocaine and apoptosis in myocardial cells . Anat Rec . 1999;257:208–216
  55. Hollander JE , Todd KH , Green G , et al.   Chest pain associated with cocaine (an assessment of prevalence in suburban and urban emergency departments) . Ann Emerg Med . 1995;26:671–676
  56. Gitter MJ , Goldsmith SR , Dunbar DN , et al.   Cocaine and chest pain (clinical features and outcomes of patients hospitalized to rule out myocardial infarction) . Ann Intern Med . 1991;115:277–282
  57. Amin M , Gabelman G , Karpel J , et al.   Acute myocardial infarction and chest pain syndromes after cocaine use . Am J Cardiol . 1990;66:1434–1437
  58. Hollander JE , Lozano M , Fairweather P , et al.   “Abnormal” electrocardiograms in patients with cocaine associated chest pain are due to “normal” variants . J Emerg Med . 1994;12:199–205
  59. Tokarski GF , Paganussi P , Urbanski R , et al.   An evaluation of cocaine-induced chest pain . Ann Emerg Med . 1990;19:1088–1092
  60. Kontos MC , Anderson FP , Ornato JP , et al.   Utility of troponin I in patients with cocaine-associated chest pain . Acad Emerg Med . 2002;9:1007–1013
  61. McLaurin M , Apple FS , Henry TD . Cardiac troponin I and T concentrations in patients with cocaine-associated chest pain . Ann Clin Biochem . 1996;33:183–186
  62. Hollander JE , Levitt MA , Young GP . Effect of recent cocaine use on the specificity of cardiac markers for the diagnosis of acute myocardial infarction . Am Heart J . 1998;135:245–252
  63. Hollander JE , Hoffman RS , Gennis P , et al.   Nitroglycerin in the treatment of cocaine associated chest pain – clinical safety and efficacy . J Toxicol Clin Toxicol . 1994;32:243–256
  64. Feldman J . Cardiovascular complications of cocaine use . N Engl J Med . 2001;345:1575
  65. Baumann BM , Perrone J , Hornig SE , et al.   Randomized, double-blind, placebo-controlled trial of diazepam, nitroglycerin, or both for treatment of patients with potential cocaine-associated acute coronary syndromes . Acad Emerg Med . 2000;7:878–885
  66. Brogan WC , Lange RA , Kim AS , et al.   Alleviation of cocaine-induced coronary vasoconstriction by nitroglycerin . J Am Coll Cardiol . 1991;18:581–586
  67. Derlet RW , Albertson TE . Potentiation of cocaine toxicity with calcium channel blockers . Am J Emerg Med . 1989;7:464–468
  68. Lange RA , Cigarroa RG , Flores ED , et al.   Potentiation of cocaine-induced coronary vasoconstriction by beta-adrenergic blockade . Ann Intern Med . 1990;112:897–903
  69. Derlet RW , Horowitz BZ . Cocaine-associated myocardial ischemia . N Engl J Med . 1996;334:535–537
  70. Rajput V , Sunnergren KP . Cocaine-associated myocardial ischemia . N Engl J Med . 1996;334:535–537
  71. Blaho K , Merigian K , Winbery S . Cocaine-associated myocardial ischemia . N Engl J Med . 1996;334:536–537
  72. Boehrer JD , Moliterno DJ , Willard JE , et al.   Influence of labetalol on cocaine-induced coronary vasoconstriction in humans . Am J Med . 1993;94:608–610
  73. Hollander JE , Wilson LD , Leo PJ , et al.   Complications from the use of thrombolytic agents in patients with cocaine associated chest pain . J Emerg Med . 1996;14:731–736
  74. Hollander JE , Hoffman RS , Burstein JL , et al.  Cocaine-Associated Myocardial Infarction Study Group   Cocaine-associated myocardial infarction (mortality and complications) . Arch Intern Med . 1995;155:1081–1086
  75. Hollander JE , Hoffman RS , Gennis P , et al.   Cocaine-associated chest pain (one year follow up) . Acad Emerg Med . 1995;2:179–184
  76. Sharma AK , Hamwi SM , Garg N , et al.   Percutaneous interventions in patients with cocaine-associated myocardial infarction (a case series and review) . Catheter Cardiovasc Interv . 2002;56:346–352
  77. Lange RA , Cigarroa RG , Yancy CW , et al.   Cocaine-induced coronary artery vasoconstriction . N Engl J Med . 1989;321:1557–1562
  78. Weber JE , Shofer FS , Larkin GL , et al.   Validation of a brief observation period for patients with cocaine-associated chest pain . N Engl J Med . 2003;348:510–517
  79. Konotos MC , Schmidt KL , Nicholson CS , et al.   Myocardial perfusion imaging with technetium-99 sestamibi in patients with cocaine-associated chest pain . Ann Emerg Med . 1999;33:639–645

PII: S0736-4679(05)00120-4

doi: 10.1016/j.jemermed.2005.01.019

The Journal of Emergency Medicine
Volume 29, Issue 2 , Pages 173-178 , August 2005