Cocaine use increases risk of death from coronary artery disease

BALTIMORE — The negative effects of snorting cocaine are well-documented, but doctors say there’s another reason to avoid the party drug. Cocaine use increases the risk of dying from coronary artery disease, warns a new study. Using a new imaging technique, researchers report that the drug is associated with factors that contribute to the narrowing of blood vessels.

Coronary artery disease typically develops over time as plaque builds up inside the arteries. This process, known as atherosclerosis, can eventually lead to life-threatening events like heart attack and stroke.

In the past, imaging techniques provided information on atherosclerosis by describing the degree of stenosis, or narrowing, in the coronary arteries. While measuring stenosis is useful, it’s not always the most precise way to assess the risk of events like heart attacks. But with the use of radiomics, a method of measuring a whole host of factors from x-ray images, researchers have been able to spot features of stenosis which are more strongly linked to sudden heart events.

Over four years, researchers at the Johns Hopkins University School of Medicine analyzed data on 300 people with “subclinical” coronary artery disease. This means the conditions is not yet severe enough to be detected with traditional methods. In total, the team examined 1,276 different radiomics factors.

Data was collected from from the Heart Study, an investigation of the effects of HIV and cocaine use on subclinical coronary artery disease. Their investigation reveals that cocaine use and HIV-infection each have different effects on changes in coronary atherosclerosis over time.

Cocaine use was significantly associated with almost a quarter of the radiomics features, while HIV infection was linked to only slightly more than 1 percent. The study also reveals that HIV infection has a more profound effect on coronary artery disease in younger people.

“Cocaine users with HIV should abstain from cocaine use to lower the risk of coronary artery disease,” the study’s lead author, Dr. Shenghan Lai, says in a statement. “This shows that not just stenosis but the nature of the plaque itself may play a very important role in risk assessment. Some people have very bad stenosis where the vessels are 90% blocked and do fine, while others with only 40% to 50% stenosis die suddenly without warning. This shows that not just stenosis but the nature of the plaque itself may play a very important role in risk assessment.”

Lai is a professor of epidemiology and public health at the Institute of Human Virology at the University of Maryland School of Medicine. He’s also an adjunct professor of epidemiology at Johns Hopkins Bloomberg School of Public Health. He says that radiomics could also help doctors better study diseases of the lungs or even cancer.

“We want to figure out why some people die early, why some die suddenly, and why some people go on and on even if they have very significant fixed disease,” he says. “The technology is there, that’s not the key obstacle.The key obstacle is that not enough physician-researchers have access to this information.”

The findings are published in the journal Radiology.

SWNS William Janes contributed to this report.