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Revista Medica de Chile Enero 2016

ARTÍCULOS DE INVESTIGACIÓN 39 Rev Med Chile 2016; 144: 39-46 Características, manejo y evolución intrahospitalaria de usuarios de drogas ilícitas con infarto agudo del miocardio Jorge Bartolucci1, Carolina Nazzal N.2,3,a, Fernando J. Verdugo1, Juan Carlos Prieto4, Pablo Sepúlveda5, Ramón Corbalán3,6. Grupo de Estudio Multicéntrico del Infarto (GEMI) Characteristics, management, and outcomes of illicit drug consumers with acute myocardial infarction Background: Consumption of illicit drugs (ID) has been associated with an increased risk of acute myocardial infarction (AMI). There is limited national evidence about the impact of substance use over the clinical presentation, management and outcomes of AMI patients. Aim: To describe the prevalence of ID consumption in patients within the Chilean Registry of Myocardial Infarction (GEMI), comparing clinical characteristics, management and outcome according to consumption status. Material and Methods: We reviewed data from the GEMI registry between 2001 and 2013, identifying 18,048 patients with AMI. The sample was stratified according to presence or absence of previous ID consumption, comparing different demographic and clinical variables between groups. Results: Two hundred eighty five patients (1.6%) had history of ID consumption (cocaine in 66%, cannabis in 35% and central nervous system stimulants in 24.0%). Compared with non-users, ID consumers were younger, predominantly male and had a lower prevalence of cardiovascular risk factors, except for tobacco smoking (86.3% and 42.5% respectively, p < 0.01). Among consumers, there was a higher percentage of ST segment elevation (85.2% and 67.8% respectively, p < 0.01) and anterior wall AMI (59.9 and 49.5% respectively, p = 0.01). Additionally, they had a higher rate of primary angioplasty (48.8% and 25.5% respectively, p < 0.01). There was no difference in hospital mortality between groups when stratified by age. Conclusions: A low percentage of patients with AMI had a previous history of ID consumption in our national setting. These patients were younger and had a greater frequency of ST segment elevation AMI, which probably determined a more invasive management. (Rev Med Chile 2016; 144: 39-46) Key words: Cannabis; Cocaine; Hospital Mortality; Myocardial Infarction; Street Drugs. 1Facultad de Medicina, Universidad de los Andes, Santiago, Chile. 2Escuela Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile. 3Sociedad Chilena de Cardiología y Cirugía Cardiovascular. 4Programa de Farmacología Molecular y Clínica, Facultad de Medicina y Departamento Cardiovascular, Hospital Clínico Universidad de Chile, Santiago, Chile. 5Hospital San Juan de Dios, Santiago, Chile. 6Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. aPhD en Salud Pública. Fuentes de apoyo financiero: Ninguno. Recibido el 4 de mayo de 2015, aceptado el 1 de octubre de 2015. Correspondencia a: Dr. Jorge Bartolucci Johnston Unidad de estudios cardiológicos, Clínica Santa María. Fernando Manterola 0530, Providencia. jbartolucci@csm.cl El consumo de drogas ilícitas (DI) representa un problema relevante para la práctica médica, tanto por su creciente prevalencia como por la morbimortalidad neuropsiquiátrica y cardiovascular asociada a esta conducta. Se estima que entre 3,5 y 7,0% de la población mundial entre los 15 y 64 años de edad ha consumido durante el último año alguna droga ilícita, incluyendo cannabis, cocaína, estimulantes del sistema nervioso central u opioides1. En nuestro país se estiman


Revista Medica de Chile Enero 2016
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