Cardiac manifestations of cocaine abuse: a cross-sectional study of asymptomatic men with a history of long-term abuse of "crack" cocaine

Simon Chakko, Aland Fernandez, Thomas A. Mellman, Fernando J. Milanes, Kenneth M. Kessler, Robert J Myerburg

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Abstract

Objectives. The objective of this study was to evaluate the prevalence of cardiac abnormalities in young, asymptomatic long-term "crack" cocaine abusers. Background, Although the cardiac complications of cocaine abuse have received widespread attention, the prevalence of cardiac abnormalities in asymptomatic long-term cocaine abusers is unknown. Methods. History, physical examination, electrocardiogram (ECG) and echocardiogram were performed in 52 consecutive long-term cocaine abusers admitted to a drug rehabilitation program. Findings were compared with those in 14 age-matched Normal volunteers and 14 age-matched normotensive patients admitted to a psychiatric service who had a pattern of smoking and alcohol consumption similar to that of the study patients. Results. The ECG findings were abnormal in 29% of cocaine abusers, and included nonspecific ST-T wave changes in 15%, abnormal ST segment elevation in 10%, old inferior infarction in 2%, old anteroseptal Infarction in 2% and abnormal precordial R wave progression in 10%. When compared with normal volunteers and control patients, cocaine abusers had increased left ventricular posterior wall thickness (1.12 vs. 0.76 and 0.85 cm, respectively, p < 0.0001), Increased septal thickness (1.13 vs. 0.76 and 0.8 cm, P < 0.001) and higher left ventricular mass index (142 vs. 84 and 94 g/m2, p < 0.0001). Left ventricular diastolic filling variables did not differ significantly among the three groups. Diastolic filling variables were similar in cocaine abusers with and without left ventricular hypertrophy, and the prevalence of left ventricular hypertrophy did not differ significantly between those who used no alcohol or <35 ml/week of alcohol and those who consumed ≥500 ml/week of alcohol. Left ventricular segmental wall motion abnormalities were present in 11 subjects (21%) and the ejection fraction was decreased (< 0.45) in 2 (4%). Conclusions. Electrocardiographic and echocardiographic abnormalities are common in long-term cocaine abusers, Despite the frequent occurrence of left ventricular hypertrophy, Doppler. derlved diasiolic filling pattern was not altered. Concomitant alcohol use did not affect the prevalence of these abnormalities.

Original languageEnglish
Pages (from-to)1168-1174
Number of pages7
JournalJournal of the American College of Cardiology
Volume20
Issue number5
DOIs
StatePublished - Nov 1 1992

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Crack Cocaine
Cocaine-Related Disorders
Cocaine
Cross-Sectional Studies
Left Ventricular Hypertrophy
Alcohols
Infarction
Healthy Volunteers
Electrocardiography
Alcohol Drinking
Physical Examination
Psychiatry
Rehabilitation
Smoking
History
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Cardiac manifestations of cocaine abuse : a cross-sectional study of asymptomatic men with a history of long-term abuse of "crack" cocaine. / Chakko, Simon; Fernandez, Aland; Mellman, Thomas A.; Milanes, Fernando J.; Kessler, Kenneth M.; Myerburg, Robert J.

In: Journal of the American College of Cardiology, Vol. 20, No. 5, 01.11.1992, p. 1168-1174.

Research output: Contribution to journalArticle

Chakko, Simon ; Fernandez, Aland ; Mellman, Thomas A. ; Milanes, Fernando J. ; Kessler, Kenneth M. ; Myerburg, Robert J. / Cardiac manifestations of cocaine abuse : a cross-sectional study of asymptomatic men with a history of long-term abuse of "crack" cocaine. In: Journal of the American College of Cardiology. 1992 ; Vol. 20, No. 5. pp. 1168-1174.
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T2 - a cross-sectional study of asymptomatic men with a history of long-term abuse of "crack" cocaine

AU - Chakko, Simon

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AU - Mellman, Thomas A.

AU - Milanes, Fernando J.

AU - Kessler, Kenneth M.

AU - Myerburg, Robert J

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N2 - Objectives. The objective of this study was to evaluate the prevalence of cardiac abnormalities in young, asymptomatic long-term "crack" cocaine abusers. Background, Although the cardiac complications of cocaine abuse have received widespread attention, the prevalence of cardiac abnormalities in asymptomatic long-term cocaine abusers is unknown. Methods. History, physical examination, electrocardiogram (ECG) and echocardiogram were performed in 52 consecutive long-term cocaine abusers admitted to a drug rehabilitation program. Findings were compared with those in 14 age-matched Normal volunteers and 14 age-matched normotensive patients admitted to a psychiatric service who had a pattern of smoking and alcohol consumption similar to that of the study patients. Results. The ECG findings were abnormal in 29% of cocaine abusers, and included nonspecific ST-T wave changes in 15%, abnormal ST segment elevation in 10%, old inferior infarction in 2%, old anteroseptal Infarction in 2% and abnormal precordial R wave progression in 10%. When compared with normal volunteers and control patients, cocaine abusers had increased left ventricular posterior wall thickness (1.12 vs. 0.76 and 0.85 cm, respectively, p < 0.0001), Increased septal thickness (1.13 vs. 0.76 and 0.8 cm, P < 0.001) and higher left ventricular mass index (142 vs. 84 and 94 g/m2, p < 0.0001). Left ventricular diastolic filling variables did not differ significantly among the three groups. Diastolic filling variables were similar in cocaine abusers with and without left ventricular hypertrophy, and the prevalence of left ventricular hypertrophy did not differ significantly between those who used no alcohol or <35 ml/week of alcohol and those who consumed ≥500 ml/week of alcohol. Left ventricular segmental wall motion abnormalities were present in 11 subjects (21%) and the ejection fraction was decreased (< 0.45) in 2 (4%). Conclusions. Electrocardiographic and echocardiographic abnormalities are common in long-term cocaine abusers, Despite the frequent occurrence of left ventricular hypertrophy, Doppler. derlved diasiolic filling pattern was not altered. Concomitant alcohol use did not affect the prevalence of these abnormalities.

AB - Objectives. The objective of this study was to evaluate the prevalence of cardiac abnormalities in young, asymptomatic long-term "crack" cocaine abusers. Background, Although the cardiac complications of cocaine abuse have received widespread attention, the prevalence of cardiac abnormalities in asymptomatic long-term cocaine abusers is unknown. Methods. History, physical examination, electrocardiogram (ECG) and echocardiogram were performed in 52 consecutive long-term cocaine abusers admitted to a drug rehabilitation program. Findings were compared with those in 14 age-matched Normal volunteers and 14 age-matched normotensive patients admitted to a psychiatric service who had a pattern of smoking and alcohol consumption similar to that of the study patients. Results. The ECG findings were abnormal in 29% of cocaine abusers, and included nonspecific ST-T wave changes in 15%, abnormal ST segment elevation in 10%, old inferior infarction in 2%, old anteroseptal Infarction in 2% and abnormal precordial R wave progression in 10%. When compared with normal volunteers and control patients, cocaine abusers had increased left ventricular posterior wall thickness (1.12 vs. 0.76 and 0.85 cm, respectively, p < 0.0001), Increased septal thickness (1.13 vs. 0.76 and 0.8 cm, P < 0.001) and higher left ventricular mass index (142 vs. 84 and 94 g/m2, p < 0.0001). Left ventricular diastolic filling variables did not differ significantly among the three groups. Diastolic filling variables were similar in cocaine abusers with and without left ventricular hypertrophy, and the prevalence of left ventricular hypertrophy did not differ significantly between those who used no alcohol or <35 ml/week of alcohol and those who consumed ≥500 ml/week of alcohol. Left ventricular segmental wall motion abnormalities were present in 11 subjects (21%) and the ejection fraction was decreased (< 0.45) in 2 (4%). Conclusions. Electrocardiographic and echocardiographic abnormalities are common in long-term cocaine abusers, Despite the frequent occurrence of left ventricular hypertrophy, Doppler. derlved diasiolic filling pattern was not altered. Concomitant alcohol use did not affect the prevalence of these abnormalities.

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