Current cocaine dependence was associated with increased odds of early repolarization (OR 4.92), bradycardia (OR 3.02), and severe bradycardia (OR 5.11) on resting ECG compared to non-users.
Case-Control (n=8,610)
Does chronic cocaine use alter resting surface ECG parameters such as bradycardia and early repolarization compared to non-users?
Chronic cocaine use is associated with significant resting ECG changes, notably early repolarization and bradycardia, which may serve as clinical markers of chronic use and indicate underlying autonomic and conduction alterations.
Effect estimate: OR 3.02
Few studies have examined the effects of chronic cocaine use on the resting surface electrocardiogram (ECG) between exposures to cocaine. Researchers compared 12-lead ECGs from 97 treatment-seeking cocaine-dependent patients, with ECG parameters from 8,513 non-cocaine-using control patients from the Atherosclerosis Risk in Communities study. After matching and adjusting for relevant covariates, cocaine use demonstrated large and statistically reliable effects on early repolarization, bradycardia, severe bradycardia, and heart rate. Current cocaine dependence corresponds to an increased odds of demonstrating early repolarization by a factor of 4.92 and increased odds of bradycardia and severe bradycardia by factors 3.02 and 5.11, respectively. This study demonstrates the novel finding that long-lasting effects of cocaine use on both the cardiac conduction and the autonomic nervous system pose a risk of adverse cardiovascular events between episodes of cocaine use, and that bradycardia is a marker of chronic cocaine use.
Sharma et al. (2014) conducted a case-control in Cocaine dependence (n=8,610). Chronic cocaine use vs. Non-cocaine-using controls was evaluated on Early repolarization, bradycardia, and severe bradycardia on resting ECG (OR 3.02). Current cocaine dependence was associated with increased odds of early repolarization (OR 4.92), bradycardia (OR 3.02), and severe bradycardia (OR 5.11) on resting ECG compared to non-users.