22
Treatment
Table 9. Substances With Abuse Potential and Adverse
Cardiovascular Effects for Patients With CCD*
Substance Potential Adverse Cardiovascular Effects
Alcohol • J-shaped relationship between alcohol intake and
cardiovascular risk in observational studies but
limited by confounding.
• Heavy alcohol use and binge drinking associated
with increased morbidity and mortality rates.
• May increase serum triglycerides.
• Potential drug-drug interactions with cardiovascular
therapies.
Cocaine, methamphetamine • Stimulation of the sympathetic nervous system.
• Platelet activation and aggregation.
• Increased myocardial oxygen demand.
• Can present with cocaine-associated chest pain.
• MI risk independent of route of administration.
Opioids • Possible association with risk of MI in chronic use.
• High potential for dependence and abuse with
chronic use.
• Potential for drug-drug interactions with
cardiovascular therapies.
Marijuana • Stimulation of the sympathetic nervous system.
• Platelet activation.
• Endothelial dysfunction.
• Carbon monoxide toxicity from smoking and
inhalation.
• Route of administration may impact toxicity,
with edible products associated with fewer acute
cardiovascular symptoms.
* List is not all inclusive.
