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Revista chilena de cardiología

versão On-line ISSN 0718-8560

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VEAS, Nicolás et al. Microvascular coronary blood flow deteriorates after percutáneous coronary angioplasty in cocaine consumers. Rev Chil Cardiol [online]. 2014, vol.33, n.2, pp.95-100. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602014000200002.

Introduction and objective: Cocaine consumption may induce microvascular coronary blood flow deterioration. Our objective was to compare microvascular coronary blood flow in patients with acute myocardial infarction and ST elevation, with or without prior consumption of cocaine. Methods: This was a case - control (1:2) observational analytic study. We measured TIMI frame count and Myocardial Blush Grade in all patients. Results: From a total of 1294 primary angioplasty, 59 patients declared cocaine consumption prior to the event. Controls were 142 patients. Consumers were younger (38 ± 10 vs 58 ± 10 years, p<0.001), predominantly male (89.8% vs 77.3%, p=0.039), had less arterial hypertension (8.5% vs 58%, p<0.001) and type 2 Diabetes Mellitus (6.8% vs 26.1%, p=0.002). Stenosis > 70% were less frequent in consumers than in controls (4.9 % vs 40.7% , p<0.001). They had lower baseline TIMI frame count (61 ± 35 vs 84 ± 28 frames, p<0.001) and stent implantation was less common (37.3% vs 89.9%, p<0.001). Final TIMI frame count was 37 ± 22 in consumers vs 29 ± 17 frames in controls, p=0.003). Cocaine was a statistically significant predictor of poor TIMI frame count in a multivariate analysis (OR 2.6, p=0.049, 95%CI 1.003-6.721). Myocardial Blush was not different between groups. Conclusions: Cocaine consumption associated to STEMI is more frequent in young male patients, with fewer cardiovascular risk factors and less severe angiographic lesions. Cocaine consumers had higher prevalence of decreased coronary microvascular flow after primary angioplasty.

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