The negative effects of cocaine sniffing are well documented and recognized, but doctors say there is another reason to avoid using this drug. A new study warns that cocaine use increases the risk of death from coronary artery disease. Using a new imaging technique, researchers reported that this drug is linked to factors that contribute to vascular narrowing. According to researchers, coronary artery disease typically develops over time, as plaques build up within the arteries.
This process, known as atherosclerosis, can eventually lead to life-threatening events such as heart attacks and strokes. In the past, imaging techniques provided information on atherosclerosis by describing the degree of narrowing or blockage in the coronary arteries. While measuring arterial narrowing is useful, it is not always the most accurate way to assess the risk of events such as heart attacks. However, by using radiomics, a method for measuring a comprehensive range of factors through X-ray images, researchers were able to identify narrowing features that are closely related to sudden cardiac events.
Over four years, researchers at Johns Hopkins University School of Medicine analyzed data from 300 individuals suffering from "subclinical" coronary artery disease, meaning the clinical symptoms are not severe enough to be detected by conventional methods. In total, the team examined 1,276 different radiomic factors. Data was also collected from the Heart Study, which investigated the effects of HIV and cocaine use on subclinical coronary artery disease. The study revealed that cocaine use and HIV infection each had different effects on changes in coronary artery stiffness over time. Additionally, cocaine use was significantly associated with nearly a quarter of coronary heart disease characteristics, while HIV infection was associated with just over 1%.
The study also found that HIV infection had a deeper impact on coronary artery disease in younger individuals. The lead author of the study, Dr. Shenghan Lai, stated: "Cocaine users infected with HIV should refrain from using cocaine to reduce the risk of coronary artery disease. This indicates that narrowing is not the only cause, but the nature of the plaques that block the arteries may play a very important role in risk assessment." He added: "Some people have severe arterial narrowing where the vessels are 90% blocked yet function well, while others die suddenly with 40% to 50% narrowing without warning. This shows that not only narrowing but also the nature of the plaques themselves may play an important role in risk assessment."
He concluded: "We want to understand why some people die early, why some die suddenly, and why some people continue to live even if they have significant stable or manifest symptoms. The technology exists, and this is not the main barrier; the main barrier is the lack of enough doctors and researchers who can access this information."
