ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2023
Cocaethylene cardiotoxicity in emergency department patients with acute drug overdose.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Enhanced and Prolonged Euphoria during Co-Use of Alcohol and Cocaine: A Narrative and Integrative Review.European addiction research · 2026Pooled it
- Letter to the Editor: "Cocaine-induced acute myocardial infarction: angiographic features and outcomes".Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Cocaine Use Disorder: Neuropathology and Exploratory Treatments.Molecular neurobiology · 2026Review
- The role of polysubstance use in the development, maintenance, and treatment of stimulant use disorders.Pharmacological reviews · 2026Review
- Clinical outcomes of chest pain with cocaine use: a propensity score-matched analysis.Internal and emergency medicine · 2025Article
- Is there a relationship between abuse of alcohol and illicit drugs seen in hair results?Drug testing and analysis · 2025Article
- Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine-A Systematic Review.Journal of clinical medicine · 2024Review
- Urine Drug Tests Indicate Higher Prevalence of Combined Alcohol and Cocaine Use Compared to Alcohol Together with Cannabis or Amphetamine-A Possible Link to Cocaethylene.Alcohol and alcoholism (Oxford, Oxfordshire) · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesCocaine use results in over 500,000 emergency department (ED) visits annually across the United States and ethanol co-ingestion is reported in 34% of these. Commingling cocaine with ethanol results in the metabolite cocaethylene (CE), which is metabolically active for longer than cocaine alone. Current literature on the cardiotoxicity of CE compared to cocaine alone is limited and lacks consensus. This study aims to fill this gap in the literature and examine cardiovascular events in cocaine use as confirmed by urine toxicology versus CE exposure.
methodsThis was a secondary data analysis of a prospective cohort study of adult patients with acute drug overdose at two urban tertiary care hospital EDs over 4 years. Patients with positive urinary cocaine metabolites were analyzed, and outcomes were compared between patients with overdose and confirmed presence of cocaine on urine toxicology (cocaine group) and patients with cocaine and ethanol use (CE group). The primary outcome was cardiac arrest. Secondary outcomes included myocardial injury and hyperlactatemia. Data were analyzed using multivariable regression models.
resultsWe enrolled a total of 199 patients (150 cocaine, 49 CE). Rates of cardiac arrest were significantly higher in the CE group compared to cocaine (6.1% vs. 0.67%, p = 0.048). Cocaine was significantly associated with myocardial injury compared to CE exposure (mean initial troponin 0.01 ng/ml vs. 0.16 ng/ml, p = 0.021), while hyperlactatemia was associated with CE exposure (mean initial lactate 4.1 mmol/L vs. 2.9 mmol/L, p = 0.038).
conclusionsWhen compared to cocaine exposure alone, CE exposure in ED patients with acute drug overdose was significantly associated with higher occurrence of cardiac arrest, higher mean lactate concentrations, and lower occurrence of myocardial injury.
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