For chest pain related to cocaine use, non-STEMI guidelines usually followed

CHICAGO — Most patients with cocaine-associated chest pain were observed by cardiologists and emergency physicians in accordance with non-STEMI guidelines for non-cocaine-associated chest pain, according to data presented at the American Heart Association Scientific Sessions.

The European Society of Cardiology guidelines recommend observing patients with chest pain who may have non-STEMI between 3 and 6 hours, but the AHA recommends that patients with cocaine-associated chest pain be observed for at least 12 hours, according to the study background.

Femke Gresnigt, MD, emergency physician at OLVG in Amsterdam, and colleagues analyzed data from 214 medical professionals who were cardiologists (n = 95) or emergency physicians (n = 117) in the Netherlands. There were 83 cardiology or emergency physician residents.

Surveys were performed from July 2015 to February 2016 to collect information on risk-stratification method, knowledge of risk, follow-up and clinical management.

Of the medical professionals in the study, all considered cocaine use as a risk factor for ACS, although 73% did not perform tests to confirm the diagnosis.

Four percent of cardiologists and emergency physicians reported they observed a patient with cocaine-associated chest pain for 12 to 24 hours.

Most responders (61.7%) reported that they adhered to the ESC non-STEMI guidelines.

“This practice [of observing patients] is not in accordance with the AHA recommendation of a 12-hour observation period,” Gresnigt and colleagues wrote. – by Darlene Dobkowski

Reference:

Gresnigt F, et al. Poster Mo1294. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.