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Clergue-Duval V, Nicolas-Sacy L, Karsinti E, Zerdazi EH, Laplanche JL, Brousse G, Marees AT, Derks EM, Henry P, Bellivier F, Vorspan F, Bloch V. Risk and Protective Factors of Lifetime Cocaine-Associated Chest Pain. Front Psychiatry 2021; 12:704276. [PMID: 34366936 PMCID: PMC8335401 DOI: 10.3389/fpsyt.2021.704276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Cocaine users often present with repetitive events of cocaine-associated chest pain (CACP), clinically resembling acute coronary syndromes. The aim of the study is to describe the specific risk factors for CACP. Method: Cocaine users (n = 316) were recruited for a multicenter cross-sectional study. Lifetime CACP history, sociodemographic factors, and lifetime use of cocaine and other substances were assessed. Thirty single nucleotide polymorphisms (SNPs) of NOS3, ROCK2, EDN1, GUCY1A3, and ALDH2 genes, suggested by the literature on coronary spasms, were selected. The associations with CACP history were tested using the chi-square test, Student's t-test and logistic regression. Results: Among the 316 subjects [78.5% men, mean age 37.5 years, (standard-deviation ±8.7)], 190 (60.1%) were daily cocaine users and 103 (32.6%) reported a lifetime CACP history. Among those with a lifetime CACP history, the median was 10 events per individual. In multivariate analysis, lifetime CACP history was associated with daily cocaine use [odds-ratio (OR) 3.24; 95% confidence intervals (1.29-9.33)], rapid route of cocaine use [OR 2.33 (1.20-4.64) vs. intranasal use], and lifetime amphetamine use [daily amphetamine use: OR 2.80 (1.25-6.32) and non-daily amphetamine use: OR 2.14 (1.15-4.04) vs. never used]. Patients with lifetime opioid maintenance treatment (OMT) reported significantly less lifetime CACP history [OR 0.35 (0.16-0.76)]. None of the selected SNPs was associated with CACP history after multiple testing corrections. Conclusions: Clinical variables describing the intensity of stimulant use were positively associated with lifetime CACP history, while OMT was negatively associated with it. Specific harm reduction strategies can target these risk factors.
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Affiliation(s)
- Virgile Clergue-Duval
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Louise Nicolas-Sacy
- APHP, Pharmacie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
| | - Emily Karsinti
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Laboratoire ClipsyD, Université Paris Nanterre, Nanterre, France
| | - El-Hadi Zerdazi
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- APHP, Service d'addictologie, DMU IMPACT, GHU Mondor, Hôpital Emile ROUX, Limeil Brévannes, France
| | - Jean-Louis Laplanche
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- APHP, Département de Biochimie et Biologie Moléculaire, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
- Faculté de Pharmacie, Université de Paris, Paris, France
| | - Georges Brousse
- Service de psychiatrie-addictologie, CHU de Clermont-Ferrand, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Andries T. Marees
- Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, Netherlands
| | - Eske M. Derks
- Queensland Institute of Medical Research Berghofer, Translational Neurogenomics Group, Brisbane, QLD, Australia
| | - Patrick Henry
- Faculté de Médecine, Université de Paris, Paris, France
- APHP, Département de Cardiologie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
| | - Frank Bellivier
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Vorspan
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Vanessa Bloch
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- APHP, Pharmacie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
- Faculté de Pharmacie, Université de Paris, Paris, France
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