CHRONIC EFFECTS OF COCAINE ON VESSELS: A SYSTEMATIC REVIEW

Background and Aim : Cocaine, a potent vasoconstrictor, stimulates immune responses, including increased cytokines. Chronic cocaine use is potentially associated with vascular damage. Although the cocaine use epidemic has fallen, its vascular consequences are increasingly seen among people in aging. The purpose of this review is to review the effects of chronic cocaine on the vessels. Methods : : This review study by searching on scientific sites: Pubmed, Embase. siencedirect Sid, SCOPUS, web of sience and Google Scholar's search engine were searched for by keywords: cocaine, vascular disease, and atherosclerosis from 1998 to 2017. The number of initial articles 42 items and the number of final papers have been reviewed 24. The articles in the descriptive-analytical and interventional group were included. Results : Chronic effects of cocaine on the vessel include endothelial damage, which results in early and severe atherosclerosis in various organs. In the heart, significant cocaine interactions with norepinephrine can lead to LVED with the effect of reducing the discharge phase and reducing contraction. Despite some discrepancies, left ventricularhypertrophy is one of the most common chronic morphological findings associated with cocaine toxicity in patients with cocaine-chest pain. Structural and functional damage in both ventricles, including decreased ejection fraction and increased systolic and steatosis, are associated with LVED. These effects and other effects (such as myocardial edema) may be due to a dose of cocaine. Other studies indicate aortic injury, including loss of strength and aorta, and aortic rigidity. In addition, asymptomatic or clinical symptoms have been shown to be associated with coronary calcification and stenosis, and are independently associated with cocaine use. In a study, after 6 months of cocaine use, coronary artery stenosis increased by 50%. Conclusion : With the spread of vascular diseases, especially coronary arteritis, among cocaine users, more methods are needed for early diagnosis and prevention of cardiovascular and cerebrovascular disease in this population. Systemic effects of cocaine can be considered as part of a harm reduction strategy. Consequently, the use of cocaine should be included in the protocols and guidelines as a risk factor for cardiovascular and cerebrovascular disease. Also, given that cocaine causes arterial toxicity, there is a health need to identify asymptomatic vascular disorders in cocaine addicts and use preventive therapies to prevent the progression of these complications.

Cocaine, vascular disease, addiction, atherosclerosis