Background: There is a lack of research regarding whether prolonged use of cocaine
would lead to increase of coronary plaque burden. Objectives: To study the effects
of cocaine use on the coronary artery plaque volume. We hypothesize the longer the
cocaine use, the greater the plaque burden. Methods: We used coronary computed tomography
angiography to evaluate plaque volumes. The study included chronic (N = 33 with 27
HIV+) and non-cocaine users (N = 15 with 12 HIV+). Chronic cocaine use was defined
as use by any route for at least 6 months, administered at least 4 times/month. The
Student's t-test was used to compare the plaque volumes between chronic and non-cocaine
users. Multivariable regression analysis adjusted for age, sex, body mass index, HIV
status, cigarette smoking, diabetes, and total cholesterol was performed to determine
the relationship between years of cocaine use and plaque volumes. Results: The total
plaque volumes between groups showed no difference (p = .065). However, the total
left anterior descending artery (LAD) plaque volume in the chronic cocaine group was
significantly higher than that in the non-cocaine group (p = .047). For each year
increase in cocaine use, total plaque volume and total LAD plaque volume increased
by 7.23 mm(3)(p = .013) and 4.56 mm(3)(p = .001), respectively. In the multivariable
analyses, both total plaque volume and total LAD plaque volume were significantly
associated with years of cocaine use (p = .039 and 0.013, respectively). Conclusion:
Prolonged cocaine use accelerates the development of sub-clinical atherosclerosis.
