Role of Stent Versus Thrombolysis in Management of Cocaine-Induced ST-Elevation Myocardial Infarction

Cocaine has been used increasingly nowadays because of its abundant availability and recreational effects. Along with that, we have been experiencing many cases presenting with cocaine intoxication and withdrawal effects, including hypertension and chest pain syndrome. In the modern era, many medical advances related to myocardial infarction treatment have been made, including not only medical therapy but also urgent or emergent reperfusion, and revascularization therapies. In percutaneous coronary revascularization therapy, a second-generation drug-eluting stent (DES) with dual antiplatelet therapy is the first-line treatment compared to bare-metal stent (BMS) with significant reduced risk of stent thrombosis and restenosis. However, there is limited clinical and research data on how to approach cocaine-induced myocardial infarction (CIMI) and it remains unclear what would be the optimal stent type we should use in CIMI. We, hereby, would like to describe a case of cocaine-related ST-segment elevation myocardial infarction (STEMI) requiring emergent percutaneous coronary intervention with a DES and clinical outcome. We also performed a literature review of cocaine-induced acute myocardial infarction management.