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March 16, 2021 Patients with a history of cocaine use who present with non-ST-segment elevation myocardial infarction have a lower risk of future major adverse cardiovascular events if treated invasively rather than with a more-conservative approach, according to a new retrospective study. Overall, invasive management, which included coronary angiography followed by PCI or CABG if needed, lowered the risk of MACE at 6 months by 28% compared with a noninvasive strategy. The results, however, point to one of the major challenges in treating patients with cocaine-associated NSTEMI, namely their ability to adhere to posttreatment dual antiplatelet therapy (DAPT). While there was no greater risk of emergent revascularization in the overall cohort, that risk was significantly elevated among patients deemed nonadherent to medical therapy who’d been treated with a drug-eluting stent, report researchers.

El pasoUnited statesMehdi shishehborShilpkumar aroraDebabrata mukherjeeL kristin newbyRichard langeMd texas tech university health sciences centerAmerican heart associationAmerican college of cardiologyMd duke clinical research instituteCase western reserve university schoolCardiovascular interventionsTreatment bestAmerican collegeNationwide readmissions database