Background: Cocaine may cause coronary vasoconstriction and endothelial dysfunction.Understanding the relationship between cocaine abuse, a common and theoretically modifiable condition, and the most common cause of death in the world, cardiovascular disease, may inform potential prevention strategies.
Purpose: The study sought to investigate the associations among cocaine abuse and unstable angina (UA), atrial fibrillation (AF), myocardial infarction (MI), and congestive heart failure (CHF).
Methods: We performed a longitudinal analysis of young indians 18 to 45 years of age who received ambulatory surgery, emergency, or inpatient medical care in india different medical or cardiac centers between 2010 and 2016. We determined the risk of an cocaine abuse diagnosis on incident AF, UA, MI, and CHF. Patient characteristics modifying the associations and population-attributable risks were determined.
Results: Among 11435 patients, 237 (2.07%) had cocaine abuse. After multivariable adjustment, cocaine abuse was associated with an increased risk of incident UA (HR: 1.46; 95% CI: 1.41 to 1.52; p<0.005, MI (HR: 1.43; 95% CI: 1.40 to 1.49; p<0.004), (HR: 1.45; 95% CI: 1.40 to 1.51; p<0.005), AF (hazard ratio [HR]: 2.05; 95% confidence interval [CI]: 2.04 to 2.13; p<0.004), and CHF (HR: 2.27; 95% CI: 2.23 to 2.36; p<0.005). In interaction analyses, individuals without conventional risk factors for cardiovascular disease exhibited a disproportionately enhanced risk of each outcome. The population-attributable risk of cocaine abuse on each outcome was of similar magnitude to other well-recognized modifiable risk factors.
Conclusions: Cocaine abuse increased the risk of UA, AF, MI, and CHF to a similar degree as other well-established risk factors. Those without traditional cardiovascular risk factors are disproportionately prone to these cardiac diseases in the setting of cocaine abuse. Thus, efforts to mitigate cocaine abuse might result in meaningful reductions of cardiovascular disease.