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Comparative cardiac pathology among deaths due to cocaine toxicity, opioid toxicity and non-drug-related causes

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Abstract:

ABSTRACT Aim 

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. Design 

Case–control. Findings 

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.

Keywords: Cardiotoxicity; cocaine; mortality; opioids

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1360-0443.2006.01601.x

Affiliations: 1: National Drug and Alcohol Research Centre, University of New South Wales, Australia, 2: Department of Forensic Medicine, Sydney South-west Area Health Service, School of Medical Sciences, University of New South Wales and Department of Pathology, University of Sydney, NSW, Australia

Publication date: December 1, 2006

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