Vitamin D deficiency is associated with significant coronary stenoses in asymptomatic African American chronic cocaine users

Research output: Contribution to journalArticle

Abstract

Background: Chronic cocaine use may lead to premature atherosclerosis, however, the prevalence of and risk factors for coronary artery disease in asymptomatic cocaine users have not been reported. Methods: Between August 2007 and June 2010, 385 African American chronic cocaine users aged 25 to 54 years were consecutively enrolled in a study to investigate the prevalence of CT angiographically-defined significant (≥ 50%) coronary stenosis and related risk factors. Sociodemographic, drug-use behavior, medical history and medication data were obtained by interview and confirmed by medical chart review. Clinical examinations were performed as well as extensive laboratory tests including those for fasting lipid profiles, HIV, high sensitivity C-reactive protein, and vitamin D. Contrast-enhanced coronary CT angiography was performed. Results: Significant coronary stenosis was detected in 52 of 385 participants (13.5%). The prevalences were 12% and 30% in those with low risk and with middle-high risk Framingham score, respectively. In those with low risk scores, the prevalences of significant stenosis were 10% and 18% in those without and with vitamin D deficiency, defined as serum 25-(OH) vitamin D <10 ng/mL (p = 0.08). Multiple logistic regression analysis revealed that vitamin D deficiency (adjusted OR = 2.18, 95% CI: 1.07-4.43) is independently associated with the presence of significant coronary stenosis after controlling for traditional risk factors. Conclusions: The study indicates that the prevalence of significant coronary stenoses is high in asymptomatic young and middle-aged African American chronic cocaine users. These findings emphasize the importance of aggressive reduction of risk factors, including vitamin D deficiency in this population.

Original languageEnglish (US)
Pages (from-to)211-216
Number of pages6
JournalInternational Journal of Cardiology
Volume158
Issue number2
DOIs
StatePublished - Jul 12 2012

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Vitamin D Deficiency
Coronary Stenosis
Cocaine
African Americans
Vitamin D
Coronary Angiography
C-Reactive Protein
Coronary Artery Disease
Fasting
Atherosclerosis
Pathologic Constriction
Cross-Sectional Studies
Logistic Models
Regression Analysis
HIV
Interviews
Lipids
Serum
Pharmaceutical Preparations
Population

Keywords

  • Chronic cocaine use
  • CT coronary angiography
  • Significant coronary stenosis
  • Vitamin D deficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Vitamin D deficiency is associated with significant coronary stenoses in asymptomatic African American chronic cocaine users",
abstract = "Background: Chronic cocaine use may lead to premature atherosclerosis, however, the prevalence of and risk factors for coronary artery disease in asymptomatic cocaine users have not been reported. Methods: Between August 2007 and June 2010, 385 African American chronic cocaine users aged 25 to 54 years were consecutively enrolled in a study to investigate the prevalence of CT angiographically-defined significant (≥ 50{\%}) coronary stenosis and related risk factors. Sociodemographic, drug-use behavior, medical history and medication data were obtained by interview and confirmed by medical chart review. Clinical examinations were performed as well as extensive laboratory tests including those for fasting lipid profiles, HIV, high sensitivity C-reactive protein, and vitamin D. Contrast-enhanced coronary CT angiography was performed. Results: Significant coronary stenosis was detected in 52 of 385 participants (13.5{\%}). The prevalences were 12{\%} and 30{\%} in those with low risk and with middle-high risk Framingham score, respectively. In those with low risk scores, the prevalences of significant stenosis were 10{\%} and 18{\%} in those without and with vitamin D deficiency, defined as serum 25-(OH) vitamin D <10 ng/mL (p = 0.08). Multiple logistic regression analysis revealed that vitamin D deficiency (adjusted OR = 2.18, 95{\%} CI: 1.07-4.43) is independently associated with the presence of significant coronary stenosis after controlling for traditional risk factors. Conclusions: The study indicates that the prevalence of significant coronary stenoses is high in asymptomatic young and middle-aged African American chronic cocaine users. These findings emphasize the importance of aggressive reduction of risk factors, including vitamin D deficiency in this population.",
keywords = "Chronic cocaine use, CT coronary angiography, Significant coronary stenosis, Vitamin D deficiency",
author = "Lai, {Hong Chen} and Fishman, {Elliot K} and Gary Gerstenblith and Brinker, {Jeffrey A} and Wenjing Tong and Sandeepan Bhatia and Barbara Detrick and Shenghan Lai",
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language = "English (US)",
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pages = "211--216",
journal = "International Journal of Cardiology",
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T1 - Vitamin D deficiency is associated with significant coronary stenoses in asymptomatic African American chronic cocaine users

AU - Lai, Hong Chen

AU - Fishman, Elliot K

AU - Gerstenblith, Gary

AU - Brinker, Jeffrey A

AU - Tong, Wenjing

AU - Bhatia, Sandeepan

AU - Detrick, Barbara

AU - Lai, Shenghan

PY - 2012/7/12

Y1 - 2012/7/12

N2 - Background: Chronic cocaine use may lead to premature atherosclerosis, however, the prevalence of and risk factors for coronary artery disease in asymptomatic cocaine users have not been reported. Methods: Between August 2007 and June 2010, 385 African American chronic cocaine users aged 25 to 54 years were consecutively enrolled in a study to investigate the prevalence of CT angiographically-defined significant (≥ 50%) coronary stenosis and related risk factors. Sociodemographic, drug-use behavior, medical history and medication data were obtained by interview and confirmed by medical chart review. Clinical examinations were performed as well as extensive laboratory tests including those for fasting lipid profiles, HIV, high sensitivity C-reactive protein, and vitamin D. Contrast-enhanced coronary CT angiography was performed. Results: Significant coronary stenosis was detected in 52 of 385 participants (13.5%). The prevalences were 12% and 30% in those with low risk and with middle-high risk Framingham score, respectively. In those with low risk scores, the prevalences of significant stenosis were 10% and 18% in those without and with vitamin D deficiency, defined as serum 25-(OH) vitamin D <10 ng/mL (p = 0.08). Multiple logistic regression analysis revealed that vitamin D deficiency (adjusted OR = 2.18, 95% CI: 1.07-4.43) is independently associated with the presence of significant coronary stenosis after controlling for traditional risk factors. Conclusions: The study indicates that the prevalence of significant coronary stenoses is high in asymptomatic young and middle-aged African American chronic cocaine users. These findings emphasize the importance of aggressive reduction of risk factors, including vitamin D deficiency in this population.

AB - Background: Chronic cocaine use may lead to premature atherosclerosis, however, the prevalence of and risk factors for coronary artery disease in asymptomatic cocaine users have not been reported. Methods: Between August 2007 and June 2010, 385 African American chronic cocaine users aged 25 to 54 years were consecutively enrolled in a study to investigate the prevalence of CT angiographically-defined significant (≥ 50%) coronary stenosis and related risk factors. Sociodemographic, drug-use behavior, medical history and medication data were obtained by interview and confirmed by medical chart review. Clinical examinations were performed as well as extensive laboratory tests including those for fasting lipid profiles, HIV, high sensitivity C-reactive protein, and vitamin D. Contrast-enhanced coronary CT angiography was performed. Results: Significant coronary stenosis was detected in 52 of 385 participants (13.5%). The prevalences were 12% and 30% in those with low risk and with middle-high risk Framingham score, respectively. In those with low risk scores, the prevalences of significant stenosis were 10% and 18% in those without and with vitamin D deficiency, defined as serum 25-(OH) vitamin D <10 ng/mL (p = 0.08). Multiple logistic regression analysis revealed that vitamin D deficiency (adjusted OR = 2.18, 95% CI: 1.07-4.43) is independently associated with the presence of significant coronary stenosis after controlling for traditional risk factors. Conclusions: The study indicates that the prevalence of significant coronary stenoses is high in asymptomatic young and middle-aged African American chronic cocaine users. These findings emphasize the importance of aggressive reduction of risk factors, including vitamin D deficiency in this population.

KW - Chronic cocaine use

KW - CT coronary angiography

KW - Significant coronary stenosis

KW - Vitamin D deficiency

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