Cocaine addicts have ‘high prevalence’ of cardiac damage
MedWire News: Cardiac damage is highly prevalent in asymptomatic cocaine addicts, Italian researchers have found.
"This may indicate the need for screening in long-term users even when they are asymptomatic," comment Giovanni Aquaro (Fondazione G Monasterio Regione Toscana CNR, Pisa) and colleagues in the journal Heart.
Aquaro and colleagues set out to prospectively evaluate the prevalence of myocardial damage in 30 cocaine addicts (83% male) with a mean age of 39 years and no history of cardiovascular disease (CVD).
The researchers conducted a comprehensive humoral, clinical, and instrumental assessment that included B-type natriuretic peptide and troponin 1 assay, echocardiography, exercise stress test, 24-hour electrocardiogram (ECG) recording, and CV magnetic resonance (CMR) examination. Participants were assessed 48 hours after cocaine withdrawal.
The findings revealed that biohumoral markers of cardiac involvement, including epinephrine and troponin I, were negative in all but one of the subjects. Subtle abnormalities in resting ECG, including lack of normal R-wave progression, were observed in 15 individuals. Echocardiography provided evidence of wall motion abnormalities in 12 individuals.
CMR evaluation showed that 83% of participants had myocardial involvement, 73% had fibrosis (23% ischemic, 50% nonischemic), and 47% had edema.
Myocardial edema is an indicator of recent damage, the authors explain, and is potentially reversible, whereas myocardial fibrosis is irreversible.
"This study indicates a high prevalence (83%) of myocardial structural damage in asymptomatic cocaine addicts," write Aquaro et al.
They caution, however, that their results - obtained in cocaine addicts with a psychiatric diagnosis, attending for rehabilitation - may not be applicable to most recreational ("weekend") cocaine users.
"The small sample size suggests a need for confirmation through larger population studies," the researchers conclude.
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By Piriya Mahendra