000			04043nam a22004577a 4500
008			170428s20172017 xxu||||| |||| 00| 0 eng d
022			_a1932-0620
040			_aOvid MEDLINE(R)
099			_a28060223
245			_aCoronary Plaque Progression and Regression in Asymptomatic African American Chronic Cocaine Users With Obstructive Coronary Stenoses: A Preliminary Study.
251			_aJournal of Addiction Medicine. 11(2):126-137, 2017 Mar/Apr
252			_aJ Addict Med. 11(2):126-137, 2017 Mar/Apr
253			_aJournal of addiction medicine
260			_c2017
260			_fFY2017
266			_d2017-05-06
501			_aAvailable online through MWHC library: March 2007 - present
520			_aCONCLUSIONS: Our findings suggest that continued cocaine use may be associated with noncalcified plaque progression, whereas reduced cocaine use may be associated with noncalcified plaque regression. Larger studies are needed to confirm these findings.
520			_aMETHODS: Fifteen African American chronic cocaine users with previously coronary computed tomography angiography (CCTA)-confirmed >50% coronary stenosis in Baltimore, Maryland, were enrolled in a study to investigate whether reduced cocaine use is associated with changes in coronary plaque burden over a 12-month period of cash-based incentive intervention, which was implemented to systematically reinforce cocaine abstinence. In addition to previous CCTA (preintervention), CCTA was performed at the intervention baseline and at postintervention. Plaque analyses were performed to determine the trajectory of plaque changes in the absence of intervention by comparing the preintervention with the intervention baseline studies; the trajectory of plaque changes associated with the intervention by comparing the intervention baseline with the postintervention studies; and (3) whether reduced cocaine use was independently associated with changes in coronary plaque burden.
520			_aOBJECTIVE: Although rapid progression of coronary atherosclerosis was observed in chronic cocaine users, it is unknown whether reduced cocaine use retards the progression of atherosclerosis. We investigated whether reduced cocaine use over a 12-month period was associated with coronary plaque regression in cocaine users.
520			_aRESULTS: During the 12-month cash-based incentive intervention period, cocaine use in participants was lower. The medians of noncalcified plaque indices were 37.8 (interquartile range [IQR] 29.3-44.0), 43.1 (IQR 38.3-49.0), and 38.7 (IQR 31.2-46.8) mm at preintervention, intervention baseline, and postintervention, respectively. Multivariable generalized estimating equation analysis showed that both total plaque and noncalcified plaque indices at preintervention were significantly lowered as compared with intervention baseline levels; both total plaque and noncalcified plaque indices after intervention were significantly lowered as compared with intervention baseline levels; and reduced cocaine use was independently associated with lower total plaque volume index (P < 0.0001) and noncalcified plaque volume index (P = 0.010).
546			_aEnglish
650			_a*Cocaine-Related Disorders/rh [Rehabilitation]
650			_a*Coronary Artery Disease/dg [Diagnostic Imaging]
650			_a*Coronary Stenosis/dg [Diagnostic Imaging]
650			_a*Disease Progression
650			_a*Plaque, Atherosclerotic/dg [Diagnostic Imaging]
650			_aAfrican Americans
650			_aCoronary Angiography
650			_aFemale
650			_aFollow-Up Studies
650			_aHumans
650			_aMale
650			_aMiddle Aged
651			_aMedStar Health Research Institute
657			_aJournal Article
700			_aVargas, Jose
790			_aBluemke DA, Brinker JA, Chen S, Fishman EK, Gerstenblith G, Kickler T, Lai H, Lai S, Li J, Sandfort V, Vargas J, Zheng G
856			_uhttps://dx.doi.org/10.1097/ADM.0000000000000282 _zhttps://dx.doi.org/10.1097/ADM.0000000000000282
942			_cART _dArticle
999			_c2798 _d2798