Cocaine-associated Chest Pain: How Common Is Myocardial Infarction?

Abstract. Objective: Prior studies addressing the incidence of acute myocardial infarction (AMI) in pa-tients with cocaine-associated chest pain have found divergent results. Previous prospective studies, which found approximately a 6 % incidence of AMI, have been criticized for selection bias. This study sought to determine the rate of AMI in patients with cocaine-associated chest pain. Methods: All patients seen in an urban university-af®liated hospital between July 1996 and February 1998 were identi®ed by ICD-9 medical records search for cocaine use and chest pain/ acute coronary syndromes. In this system, all faculty admit all patients with cocaine-associated chest pain for at least 23-hour observation periods. Data col-lected included demographics, medical and cocain