The likelihood of a heart attack increases 23-fold in the hour after cocaine use, according to a study published in the June 1 issue of Circulation, a journal of the American Heart Association. The study on myocardial infarction interviewed 3,946 adult patients of all ages at 64 hospitals nationwide. It showed a strong link between recent cocaine use and heart attacks. Each of the patients interviewed had suffered a heart attack. The study found 38 patients who claimed to have used cocaine up to a year prior to the attack, and 9 who had used in the hour leading up to their incident (Murray A. Mittleman, M.D., et al., "Triggering of Myocardial Infarcation by Cocaine," Circulation, June 1, 1999, pp. 2737-2741; Hannah Wunsch, "Cocaine Use Transiently Increases Heart-Attack Risk," The Lancet, June 5, 1999)

Murray Mittleman, M.D., an internist at Harvard Medical School's Beth Israel Deaconess Medical Center and leader of the study, said that the risk of heart attack dropped off significantly once an hour had passed from the time of cocaine use. Of the cocaine users, the average age at time of heart attack was 44. The average age for all national heart attack victims is 61. Despite the small group of recent cocaine use subjects, the researchers found their conclusions to be statistically significant at a 95% confidence interval. According to Mittleman, "[cocaine use is] larger than all of the other triggers that bring on the onset of a heart attack" (Troy Goodman, "Cocaine Users Face a Huge Risk of Heart Attacks, Study Proves," Seattle Post-Intelligencer, June 2, 1999).

Murray Mittleman, M.D. - Harvard Medical School, 25 Shattuck St., Boston, MA 02115-6092 Tel: (617) 632-7653, Fax: (617) 632-7675 E-mail: <mitm@epinet.harvard.edu>.•