Abstract 3871: Long-term Cocaine Use is Associated with Coronary Stenosis in Subjects with No Detectable Coronary Artery Calcification.
Objective: Prior studies have demonstrated a relationship between long-term cocaine use and subclinical atherosclerosis as evidenced by the presence of high coronary artery calcium (CAC) scores. However, prospective and observational studies on CAC have shown that a small percentage of individuals have future cardiovascular events in absence of detectable CAC. Computed tomographic angiography (CTA) is a practical and promising tool that can identify patients who have coronary stenosis in the absence of CAC.
Methods and: A total of 243 African-American individuals residing in the Baltimore area were enrolled in an observational study investigating the effect of cocaine use on subclinical atherosclerosis. Study participants were ages 25–54 years. Subjects who had a history of hypertension or ischemic heart disease on the basis of clinical history, electrocardiographic or echocardiographic evidence of prior infarction were excluded from this analysis. Coronary calcification, the presence of coronary plaque, and the presence of a coronary stenosis (> 20% diameter stenosis) were assessed with a 64 slice Siemens multi-detector CT scanner; 74 subjects with detectable CAC were excluded from the final analysis.
Results: A total of 169 study participants (mean age of 42± 6 years, 39% females) had no CAC. The mean cholesterol level was 166±34 mg/dl. The presence of coronary stenosis was observed on 19 (11%) subjects, and 8 had luminal stenosis of ≥50%. Univariate logistic regression analysis indicated that long-term (> 15 years) cocaine use was marginally associated with a coronary stenosis (crude OR= 2.6 with 95% CI: 0.96–6.93). Multiple logistic regression analysis, including long term use of cocaine and other illegal drugs, age, sex, family history, lipids, hsCRP, cigarette smoking, alcohol use, glucose level, blood pressure, and body mass index yielded a final model demonstrating that long-term cocaine use was independently associated with the presence of coronary stenosis (OR: 2.85, 95% CI: 1.03–7.83),
Conclusions: Long-term cocaine use is independently associated with the presence of coronary stenosis in individuals with no