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Correspondence
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Volume 345:1575-1576 November 22, 2001 Number 21
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Cardiovascular Complications of Cocaine Use

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To the Editor: In their article on the cardiovascular complications of cocaine use, Lange and Hillis (Aug. 2 issue)1 have not presented a balanced review of the controversial aspects of the management of acute coronary syndromes, particularly myocardial infarction with ST-segment elevation induced by cocaine exposure. In the American Heart Association's treatment guidelines, no reference is provided for the statement that "intracoronary administration of thrombolytics or coronary vasodilators is preferred to blind peripheral administration" in patients with a drug-induced acute coronary syndrome that does not respond to the recommended treatments.2 This statement is directly contradicted by the statement in the . . . [Full Text of this Article]

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