Comparative cardiac pathology among deaths due to cocaine toxicity, opioid toxicity and non-drug-related causes.
OBJECTIVE
To compare cardiac and cerebrovascular pathology among deaths due to cocaine toxicity, deaths due to opioid toxicity and deaths from hanging that were toxicologically negative for cocaine/opioids.


METHODS
Case-control.


RESULTS
The cocaine group had significantly higher proportions of left ventricular hypertrophy and ischaemic heart disease than either comparison group. Coronary artery atherosclerosis was also detected in significantly higher proportions of cocaine cases than in either comparison group. The cocaine group was more likely than either comparison group to have atherosclerosis of the left anterior descending coronary artery, right coronary artery and circumflex artery. Only in the left anterior descending coronary artery did the cocaine group exhibit higher levels of moderate-severe atherosclerosis. Cocaine cases also had significantly higher levels of cerebrovascular atherosclerosis than either comparison group.


CONCLUSIONS
Levels of cardiac and cerebrovascular pathology were higher among cocaine users than either comparison group. The high levels of cardiac and cerebrovascular pathology seen among cocaine cases do not appear to be artefacts of a drug-dependent life-style, but relate specifically to cocaine.
Darke
Shane
S
National Drug and Alcohol Research Centre, University of New South Wales, Australia.
Kaye
Sharlene
S
Duflou
Johan
J
D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000506:poisoning*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000139:chemically induced* / Q000401:mortality / Q000503:physiopathology; D003042:Cocaine / Q000506:poisoning*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D013405:Suicide
D000701:Analgesics, Opioid; D003042:Cocaine