[Oxidative stress and inflammatory markers in cocaine users with acute coronary syndrome].

OBJECTIVE

Inflammation and oxidative stress take part in the development of the pathogenesis of acute coronary syndromes (ACS). The aim of this study was to analyze serum concentrations of high sensitivity C-reactive protein (PCR-as) and malondialdehyde (MDA) in cocaine consumer patients and ACS.

METHODS

We carried out a retrospective analysis of 43 patients with ACS and a positive urine test for cocaine, who were compared to a sample of 49 patients with this diagnosis and a negative test. We evaluated the clinical, laboratory, electrocardiographic and hemodynamic features.

RESULTS

Both groups were similar in clinical, laboratory, electrocardiographic and hemodynamic features, except those patients with ACS and a positive cocaine test who were younger and had a predominantly transient ST-segment elevation. PCR-as values were lower in the ACS and cocaine positive group (4.82+/-0.67 versus 5.34+/-0.81mg/L, p <0.0035). In contrast, MDA concentrations were higher (0.66+/-0.50 versus 0.31+/-0.09nmol/ml, p <0.0001). Likewise, in the multivariate analysis, patients with ACS and cocaine positive test were related, on an independent form, to oxidative stress.

CONCLUSIONS

Oxidative stress plays a major role on inflammation in the different mechanisms involving cocaine in the pathogenesis of ACS, independently of the age and cardiovascular risk factors.