Porras-Perales Óscar, Segovia-Reyes Jorge, Crespo-Delgado Ángela, Ruiz-González Diego, Flores-López María, Medina-Vera Dina, Sánchez-Marín Laura, Martín-Chaves Laura, Requena-Ocaña Nerea, Molina-Ramos Ana Isabel, Ruiz-Ruiz Juan Jesús, Rodríguez de Fonseca Fernando, Jiménez-Navarro Manuel, Rodríguez-Capitán Jorge, Pavón-Morón Francisco Javier, Serrano Antonia
The Biomedical Research Institute of Málaga and Nanomedicine Platform (IBIMA Plataforma BIONAND), 29590, Málaga, Spain.
Cardiology and Cardiovascular Surgery Department, Virgen de la Victoria University Hospital, 29010, Málaga, Spain.
Sci Rep. 2025 Jul 1;15(1):21887. doi: 10.1038/s41598-025-08041-y.
Cocaine use is a well-established cardiovascular risk factor, further enhanced by concurrent alcohol use. However, cardiovascular risk is poorly managed in individuals with cocaine use disorder (CUD). This observational, cross-sectional case-control study assessed cardiac troponins T (cTnT) and I (cTnI) as biomarkers of myocardial injury in patients with CUD and/or alcohol use disorder (AUD) during abstinence. Eighty-four participants were categorized by primary substance use [cocaine (CUD, with or without AUD), alcohol (AUD), and healthy controls] and further stratified by cardiovascular diagnosis [cardiovascular (CV) and non-cardiovascular (non-CV)]. After clinical assessment, blood samples were collected for high-sensitivity cTnT and cTnI assays, and for inflammatory mediators. Patients exhibited a high prevalence of psychiatric comorbidities (67.9%). The cocaine group exhibited higher cTnT levels (p < 0.001), while the alcohol group had higher cTnI levels (p < 0.05) compared to controls. The non-CV group also had elevated troponin levels, with CUD patients displaying higher cTnT levels than AUD patients. Additionally, cTnI levels were lower in the cocaine group compared to the alcohol group (p < 0.01), and the CV group exhibited lower cTnI levels than the non-CV group (p = 0.001). CUD severity correlated with cTnT levels, while AUD severity correlated with both troponins. Inflammatory mediators correlated with troponins, particularly cTnT. Results indicate distinct troponin alterations in CUD and AUD patients, even without cardiovascular diagnosis, underscoring the importance of cardiovascular risk assessment in addiction treatment.
使用可卡因是一个已被充分证实的心血管危险因素，同时饮酒会进一步加剧这种风险。然而，可卡因使用障碍（CUD）患者的心血管风险管理不善。这项观察性横断面病例对照研究评估了在戒断期间，心脏肌钙蛋白T（cTnT）和肌钙蛋白I（cTnI）作为CUD和/或酒精使用障碍（AUD）患者心肌损伤生物标志物的情况。84名参与者按主要物质使用情况进行分类[可卡因（CUD，有或无AUD）、酒精（AUD）和健康对照]，并进一步按心血管诊断进行分层[心血管（CV）和非心血管（非CV）]。经过临床评估后，采集血样用于高敏cTnT和cTnI检测以及炎症介质检测。患者精神共病的患病率很高（67.9%）。与对照组相比，可卡因组的cTnT水平更高（p < 0.001），而酒精组的cTnI水平更高（p < 0.05）。非CV组的肌钙蛋白水平也升高，CUD患者的cTnT水平高于AUD患者。此外，可卡因组的cTnI水平低于酒精组（p < 0.01），CV组的cTnI水平低于非CV组（p = 0.001）。CUD严重程度与cTnT水平相关，而AUD严重程度与两种肌钙蛋白均相关。炎症介质与肌钙蛋白相关，尤其是cTnT。结果表明，即使没有心血管诊断，CUD和AUD患者的肌钙蛋白也有明显改变，这凸显了在成瘾治疗中进行心血管风险评估的重要性。
