Cocaine Use and Subclinical Coronary Artery Disease in Caucasians

Abstract

Objective: Cocaine remains among the most commonly used and trafficked illicit drug in the world, and its use increases myocardial demand from elevated heart rate and blood pressure, and causes coronary vasospasm leading to myocardial infarction (MI). Surrogate markers for atherosclerosis of sub-clinical coronary artery disease (CAD) are often used to assess the presence of atherosclerosis in high-risk patients. Carotid intima media thickness (CIMT) as a surrogate marker for atherosclerosis is an independent predictor of future cardiovascular (CV) events and is routinely used in clinical studies. The objective of this preliminary study is to provide the baseline information on the presence of subclinical CAD in Caucasians with chronic cocaine use disorder using CIMT as a surrogate marker. Method: The study inclusion criteria included: a) Caucasian adult, 18 yrs and older with cocaine use disorder, as defined in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5); and b) able to understand and sign the consent form (provided in English only). 40 participants were selected using convenient sampling, approached, and screened. Result: The mean LDL (low density lipoprotein), HDL (high density lipoprotein), and total cholesterol of the participants were within normal ranges. The mean right CIMT was 0.57 mm (± 0.01) and left CIMT was 0.59 mm (± 0.1). CIMT was found to be associated with route administration (p=0.0036) and smoking route had a significant positive association with the CIMT. Discussion: This study’s preliminary findings of no association between chronic cocaine use and sub-clinical CAD measured by CIMT in asymptomatic, young-to-middle-aged adult Caucasian cocaine users are new and in order to support these findings, larger prospective studies are warranted.