Cocaine increasing heart attack and stroke in young adults

27 May 2011

Heart attacks and unstable angina (acute coronary syndrome) in young people are becoming more common, in line with a worldwide boom in use of cocaine, experts warn. 

Dr Gordian Fulde, head of emergency services at St Vincent's Hospital in inner-city Sydney, said he was seeing cardiovascular events in young patients "many times a week".

"Most young people we get with this, in the cocaine-taking genre, their hearts aren't too sick so they usually come to us with chest pain, and when we do blood tests for troponin [a chemical released during a heart attack] ... it is raised, so they have had heart muscle damage," he said.

"It's not just the heart - we've seen people with strokes even in late teenage and early 20s ... people who have had small strokes because of taking cocaine."

He was commenting on a study showing 22 per cent of patients aged under 50 who presented with acute coronary syndrome at a Barcelona hospital in 2008 reported using cocaine, compared with 7 per cent in 2001 (European Heart Journal 2011; 32: 1244-50).

The younger patients also had greater injury to the heart muscle and more frequent complications compared with non-cocaine users with acute coronary syndrome, the authors reported.

The proportion of heart and stroke events brought on by cocaine use was much less in Australia, at "less than 5 per cent", Dr Fulde estimated.

"It's still a minor [cause of acute coronary syndrome] although there is more cocaine coming around, and more cocaine is being used," he said.

"I had a patient this morning who took nearly a gram of cocaine, which is a very large amount."

Dr Alex Wodak, director of the hospital's Alcohol and Drug Service, said it was a matter of debate as to whether cocaine use was rising in Australia.

"Cocaine [criminal] arrests are going up quite significantly but cocaine adverse health events are not," he said.

"The cocaine market may be moving through a transition and so the indicators may be mixed for a while."

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