Kolodgie F D, Virmani R, Cornhill J F, Herderick E E, Malcom G T, Mergner W J
Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Atherosclerosis. 1992 Nov;97(1):53-62. doi: 10.1016/0021-9150(92)90050-q.
Several recent autopsy reports indicate an increased prevalence of coronary atherosclerosis in ischemic heart disease temporally associated with cocaine abuse. The objective of this study was to conduct a retrospective analysis of sudanophilic lesions in young asymptomatic individuals who abused cocaine. Twenty-six cases (15-34-year-old black males) were examined from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. Sixteen subjects (mean age 25 +/- 1 years) had a positive toxicologic screen for cocaine and/or its major metabolites at autopsy and were confirmed habitual cocaine abusers. The remaining 10 cases (mean age 24 +/- 2 years) were subjects with a negative toxicologic screen at autopsy and no history of illicit drug abuse. Post-mortem blood was collected for lipoprotein analysis and determination of smoking status. The aorta and right coronary arteries were stained with Sudan IV and the degree and extent of sudanophilia was quantitated by image analysis. Multiple linear regression analysis of cocaine, age, smoking status, VLDL+LDL-C/HDL-C ratio and HDL-C as predictor variables of percentage intimal surface involvement, revealed an association between cocaine abuse and the extent of sudanophilia in both the thoracic and abdominal aorta (P = 0.002 and 0.049, respectively). Analysis of risk factors or of cocaine abuse as predictors of sudanophilia did not achieve statistical significance in the right coronary artery. These preliminary results suggest that habitual use of cocaine, through unknown mechanism(s), increases aortic sudanophilia independent of traditional risk factors.
最近的几份尸检报告表明，在与可卡因滥用存在时间关联的缺血性心脏病中，冠状动脉粥样硬化的患病率有所增加。本研究的目的是对滥用可卡因的年轻无症状个体的嗜苏丹性病变进行回顾性分析。从青少年动脉粥样硬化病理生物学决定因素（PDAY）研究中检查了26例病例（15 - 34岁的黑人男性）。16名受试者（平均年龄25±1岁）在尸检时可卡因和/或其主要代谢物的毒理学筛查呈阳性，并被确认为习惯性可卡因滥用者。其余10例（平均年龄24±2岁）是尸检时毒理学筛查呈阴性且无非法药物滥用史的受试者。采集死后血液进行脂蛋白分析和吸烟状况测定。主动脉和右冠状动脉用苏丹IV染色，并通过图像分析对嗜苏丹程度和范围进行定量。以可卡因、年龄、吸烟状况、极低密度脂蛋白 + 低密度脂蛋白 - 胆固醇/高密度脂蛋白 - 胆固醇比值和高密度脂蛋白 - 胆固醇作为内膜表面受累百分比的预测变量进行多元线性回归分析，结果显示可卡因滥用与胸主动脉和腹主动脉的嗜苏丹程度之间存在关联（分别为P = 0.002和0.049）。在右冠状动脉中，作为嗜苏丹性预测因素的危险因素或可卡因滥用分析未达到统计学意义。这些初步结果表明，习惯性使用可卡因通过未知机制增加主动脉嗜苏丹性，且独立于传统危险因素。
