Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review
<b>Background</b>: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/5/1475 |
| _version_ | 1797264331961794560 |
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| author | Jan van Amsterdam Femke Gresnigt Wim van den Brink |
| author_facet | Jan van Amsterdam Femke Gresnigt Wim van den Brink |
| author_sort | Jan van Amsterdam |
| collection | DOAJ |
| description | <b>Background</b>: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases the cardiovascular risk compared to the use of cocaine alone. <b>Method</b>: A systematic review of human studies comparing the cardiovascular risk of co-used cocaine and alcohol with the use of cocaine alone. <b>Results</b>: Despite a higher myocardial workload induced by the co-use of cocaine and alcohol and the potentiation of cocaine’s cardiovascular effects by alcohol, the findings on the risk and severity of cardiovascular symptoms due to combined use are inconsistent. However, the co-use of cocaine and alcohol clearly leads to higher mortality. Interestingly, the presence of cocaethylene, a unique metabolite generated only via a pharmacokinetic interaction between alcohol and cocaine, carries an 18- to 25-fold increase over the absence of cocaethylene (cocaine-alone users) in the risk of sudden death and is associated with myocardial injury and cardiac arrest, probably due to the inhibition of cardiac ion channels by cocaethylene. <b>Conclusion</b>: Despite the inconsistency in some of the results, it is concluded that the co-use of cocaine and alcohol poses an additional risk of cardiovascular fatalities compared to the use of cocaine alone. |
| first_indexed | 2024-04-25T00:27:13Z |
| format | Article |
| id | doaj.art-e72825cc69ad4c88b0e69756d47229b1 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-25T00:27:13Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e72825cc69ad4c88b0e69756d47229b12024-03-12T16:48:36ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01135147510.3390/jcm13051475Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic ReviewJan van Amsterdam0Femke Gresnigt1Wim van den Brink2Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1012 WP Amsterdam, The NetherlandsEmergency Department, OLVG Hospital, Oosterpark 9, 1091 AC Amsterdam, The NetherlandsDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1012 WP Amsterdam, The Netherlands<b>Background</b>: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases the cardiovascular risk compared to the use of cocaine alone. <b>Method</b>: A systematic review of human studies comparing the cardiovascular risk of co-used cocaine and alcohol with the use of cocaine alone. <b>Results</b>: Despite a higher myocardial workload induced by the co-use of cocaine and alcohol and the potentiation of cocaine’s cardiovascular effects by alcohol, the findings on the risk and severity of cardiovascular symptoms due to combined use are inconsistent. However, the co-use of cocaine and alcohol clearly leads to higher mortality. Interestingly, the presence of cocaethylene, a unique metabolite generated only via a pharmacokinetic interaction between alcohol and cocaine, carries an 18- to 25-fold increase over the absence of cocaethylene (cocaine-alone users) in the risk of sudden death and is associated with myocardial injury and cardiac arrest, probably due to the inhibition of cardiac ion channels by cocaethylene. <b>Conclusion</b>: Despite the inconsistency in some of the results, it is concluded that the co-use of cocaine and alcohol poses an additional risk of cardiovascular fatalities compared to the use of cocaine alone.https://www.mdpi.com/2077-0383/13/5/1475cocainealcoholcocaethylenemyocardial infarctionangina pectorismortality |
| spellingShingle | Jan van Amsterdam Femke Gresnigt Wim van den Brink Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review Journal of Clinical Medicine cocaine alcohol cocaethylene myocardial infarction angina pectoris mortality |
| title | Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review |
| title_full | Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review |
| title_fullStr | Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review |
| title_full_unstemmed | Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review |
| title_short | Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review |
| title_sort | cardiovascular risks of simultaneous use of alcohol and cocaine a systematic review |
| topic | cocaine alcohol cocaethylene myocardial infarction angina pectoris mortality |
| url | https://www.mdpi.com/2077-0383/13/5/1475 |
| work_keys_str_mv | AT janvanamsterdam cardiovascularrisksofsimultaneoususeofalcoholandcocaineasystematicreview AT femkegresnigt cardiovascularrisksofsimultaneoususeofalcoholandcocaineasystematicreview AT wimvandenbrink cardiovascularrisksofsimultaneoususeofalcoholandcocaineasystematicreview |