Cardiovascular changes research and characterization of cocaine and derivate user and/or no longer users / Pesquisa de alterações cardiovasculares e caracterização de pacientes usuarios e ex-usuarios de cocaina e/ou derivados

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

In Brazil, cocaine consumption has been increased in the last decades, about 1.076.000 of people admitted the previous use in 2001. This abusive use evidenced cardiovascular events related to such substances. To research cardiovascular alterations and risk factors, this observational traverse study evaluated cocaine users, assisted by psychiatry discipline of the Hospital de Clinicas of the Universidade Estadual de Campinas, between November 2004 and April 2006. These patients were directed for treatment of chemical dependence and not for cardiovascular symptoms as main complaint. 40 patients were included, smaller then 70 years old, and were excluded those who had limitable diseases, and couldn?t accomplish the protocol. They underwent the evaluation of consumption, abstinence and personal characteristics through a questionnaire. General and directed anamneses and physical exam were proceeded. Evaluation exams were requested: thorax x-ray; laboratorials; electrocardiogram; echocardiogram with Doppler, color and tissue Doppler; stress test and flow mediated vasodilatation, according to the American College of Cardiology guidelines. When needed, the patients were directed for other investigation and treatment of risk factors. The statistical analysis determined averages, medium and percentage of occurrence of events and the X ² test, and Exact Test of Fisher were used to evaluate statistical significance among occurrence of events a little frequency. The sample was constituted of majority man, white, single, aged between 17 and 50 years (average of 32,25). The tobacco (more prevalent risk factor) and alcohol consumption (initiated in school age) have the frequency of 82,5% and 89,7% respectively; the one of canabis activates of 97,5%. The most of the patients used to use other substances and consumed more than one illegal drug simultaneously. Cocaine consumption, have a latter age of beginning its frequency of use was more than five days a week, and the powdered and crack consumption admitted by 67,5% of the patients. As for the presence of symptoms, the typical angina linked the largest risk of cardiovascular events (P=0.003), but this pain tends to be minimized by the users. The physical exam didn t present significant changes related to the consumption. At the time of the exams, the patients presented medium abstinence of 30 days. The C protein was the laboratorial exam that appears to be linked to the cocaine use. The electrocardiogram and the stress test didn t present significant alterations. The echocardiogram found alterations that were compatible within literature data. The endothelial reactivity change was detected in 71% of the patients, and the smaller abstinence than 30 days until 60 days was statistically significant (p=0,002), and could indicate a cocaine endothelial action, taking to smallest vasodilatation, increasing the cardiovascular risk of these patients. To the coronary cathetherism were evidenced significant obstructive lesions in two cases, already suspected to have ischemic disease. It was not possible to do the prospective evaluation of 64% of the patients that didn t assist to the recall

ASSUNTO(S)

vasodilaction enfarte do miocardio endothelium cocaine endotelio cardiovascular system cocaina myocardial infarction sistema cardiovascular vasodilatação

ACESSO AO ARTIGO

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