Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 21:12:704276.
doi: 10.3389/fpsyt.2021.704276. eCollection 2021.

Risk and Protective Factors of Lifetime Cocaine-Associated Chest Pain

Virgile Clergue-Duval  1   2   3   4 , Louise Nicolas-Sacy  5 , Emily Karsinti  1   2   3   6 , El-Hadi Zerdazi  2   7 , Jean-Louis Laplanche  2   8   9 , Georges Brousse  10 , Andries T Marees  11 , Eske M Derks  12 , Patrick Henry  4   13 , Frank Bellivier  1   2   3   4 , Florence Vorspan  1   2   3   4 , Vanessa Bloch  2   3   5   9
Affiliations

Risk and Protective Factors of Lifetime Cocaine-Associated Chest Pain

Virgile Clergue-Duval et al. Front Psychiatry. .

Abstract

Introduction: Cocaine users often present with repetitive events of cocaine-associated chest pain (CACP), clinically resembling acute coronary syndromes. The aim of the study is to describe the specific risk factors for CACP. Method: Cocaine users (n = 316) were recruited for a multicenter cross-sectional study. Lifetime CACP history, sociodemographic factors, and lifetime use of cocaine and other substances were assessed. Thirty single nucleotide polymorphisms (SNPs) of NOS3, ROCK2, EDN1, GUCY1A3, and ALDH2 genes, suggested by the literature on coronary spasms, were selected. The associations with CACP history were tested using the chi-square test, Student's t-test and logistic regression. Results: Among the 316 subjects [78.5% men, mean age 37.5 years, (standard-deviation ±8.7)], 190 (60.1%) were daily cocaine users and 103 (32.6%) reported a lifetime CACP history. Among those with a lifetime CACP history, the median was 10 events per individual. In multivariate analysis, lifetime CACP history was associated with daily cocaine use [odds-ratio (OR) 3.24; 95% confidence intervals (1.29-9.33)], rapid route of cocaine use [OR 2.33 (1.20-4.64) vs. intranasal use], and lifetime amphetamine use [daily amphetamine use: OR 2.80 (1.25-6.32) and non-daily amphetamine use: OR 2.14 (1.15-4.04) vs. never used]. Patients with lifetime opioid maintenance treatment (OMT) reported significantly less lifetime CACP history [OR 0.35 (0.16-0.76)]. None of the selected SNPs was associated with CACP history after multiple testing corrections. Conclusions: Clinical variables describing the intensity of stimulant use were positively associated with lifetime CACP history, while OMT was negatively associated with it. Specific harm reduction strategies can target these risk factors.

Keywords: ALDH2; GUCY1A3; acute coronary syndrome; chest pain; cocaine; opioid maintenance treatment; rs2238151; single nucleotide polymorphism.

PubMed Disclaimer

Conflict of interest statement

In the past 5 years, FV had congress fees paid by CAMURUS AB (2018, 2019), and RECORDATI (2020). FV gave a single lecture for RECORDATI (2020) and served in advisory boards for CAMURUS AB (2019), and ACCORD HEALTH CARE (2021). All payments were made to a research entity and not directly to FV. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. United Nations Office on Drugs and Crime . Division for Policy Analysis and Public Affairs. World Drug Report 2019. (2019). Vienna. Available online at: https://wdr.unodc.org/wdr2019/ (accessed July 1, 2021).
    1. Substance Abuse and Mental Health Services Administration . Key Substance Use and Mental Health Indicators in the United States: Results From the 2018 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; (2019). Available online at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNatio... (accessed July 1, 2021).
    1. European Monitoring Centre for Drugs and Drug Addiction . European Drug Report 2019: Trend and Developments. Lisbon: Office for Official Publications of the European Communities; (2019). Available online at: https://www.emcdda.europa.eu/system/files/publications/11364/20191724_TD... (accessed July 1, 2021).
    1. Milpied T, Clergue-Duval V, Vorspan F. Épidémiologie des substances illicites en France [Epidemiology of illicit substances in France]. Rev Prat. (2020) 70:657–9. - PubMed
    1. Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N. Engl J Med. (2001) 345:351–8. 10.1056/NEJM200108023450507 - DOI - PubMed