Your browser doesn't support javascript.
loading
Application of European Society of Cardiology guidelines for evaluating acute coronary syndrome risk in low-risk patients with cocaine-associated chest pain: Findings from the RISK study - An observational analysis.
Gresnigt, F M J; Heikamp, L K; van Essen, J J W; Walraven, L F J; van Ofwegen-Hanekamp, C E E; Mollink, S; Franssen, E J F; de Lange, D W; Riezebos, R K.
Afiliación
  • Gresnigt FMJ; Emergency Department, OLVG Hospital, Oosterpark 9, Amsterdam 1091 AC, the Netherlands.
  • Heikamp LK; Dutch Poison Information Center (DPIC), UMC Utrecht, University Utrecht, Utrecht 3508 GA, the Netherlands.
  • van Essen JJW; Emergency Department, OLVG Hospital, Oosterpark 9, Amsterdam 1091 AC, the Netherlands.
  • Walraven LFJ; Emergency Department, OLVG Hospital, Oosterpark 9, Amsterdam 1091 AC, the Netherlands.
  • van Ofwegen-Hanekamp CEE; Emergency Department, Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht 3582KE, the Netherlands.
  • Mollink S; Cardiology Department, Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht 3582KE, the Netherlands.
  • Franssen EJF; Emergency Department, Haaglanden Medical Centre, Lijnbaan 32, the Hague 2512VA, the Netherlands.
  • de Lange DW; Hospital pharmacy department, OLVG Amsterdam, Oosterpark 9, Amsterdam 1091 AC, the Netherlands.
  • Riezebos RK; Dutch Poison Information Center (DPIC), UMC Utrecht, University Utrecht, Utrecht 3508 GA, the Netherlands.
Toxicol Rep ; 13: 101680, 2024 Dec.
Article en En | MEDLINE | ID: mdl-39006369
ABSTRACT

Background:

Cocaine was the drug of choice in 4.7 % of all recreational drug-related emergency department visits. Of these patients, 40 % present with cocaine-associated chest pain, of whom 4.7 % develop an acute coronary syndrome. The American Heart Association recommends a 12-hour observation period for these patients.

Objective:

This study primarily aimed to ascertain whether the European Society of Cardiology non-ST-elevation myocardial infarction guidelines can be safely applied to rule-out acute coronary syndrome in low-risk patients with cocaine-associated chest pain.

Methods:

For this prospective observational cohort study, patients, aged 18-45 years old, who presented with cocaine-associated chest pain and were risk stratified as low risk according to the European Society of Cardiology non-ST-elevation myocardial infarction guidelines and therefore discharged home without prolonged observation period, were included. They were followed to assess major adverse cardiac events four weeks after presentation to the emergency department or chest pain unit. Cocaine use was confirmed with urine toxicology screening.

Results:

A total of 107 patients were included and analysed. The accuracy of the self-reported history of recent cocaine use was 94 %. Post-discharge cocaine use persisted among 32 % of patients. None of the included 107 patients died and major adverse cardiac event within four weeks did not occur among 97 patients with available data regarding MACE.

Conclusion:

Ruling out an acute coronary syndrome using the European Society of Cardiology non-ST-elevation myocardial infarction guidelines is likely to be safe for patients with cocaine-associated chest pain, however this study was underpowered to reach definitive conclusions.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Toxicol Rep Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Toxicol Rep Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Irlanda