Elevated C-reactive protein levels are associated with endothelial dysfunction in chronic cocaine users

Objective: To examine the relationship of the serum C-reactive protein (CRP) and endothelial function and their associations with coronary artery calcification, lipid profile and cardiac changes. Methods: The analyses for serum lipids and CRP, echocardiography, spiral computed tomography scans and endothelial function assay were performed in 53 participants with a history of chronic cocaine use. Results: There were no statistically significant differences in demographic characteristics and drug use between CRP normal (< 1.9 mg/l) and abnormal groups. The brachial artery diameter percentage changes in the third scan (immediately after deflation of cuff) and the fourth scan (90 s after deflation of cuff) were significantly associated with the CRP levels (the third: beta = -0.054, S.E. = 0.027; P = 0.028; the fourth: beta = -0.065, S.E. = 0.026; P = 0.016). The multiple regression models showed that CRP was the only significant predictor of artery diameter changes (%) in these two scans. The CRP abnormal group had more coronary artery calcification (calcium scores > 5, 16.7 vs. 0%; P = 0.036) and more cardiac diastolic dysfunction expressed as deceleration time > 240 ms (16.7 vs. 0%; P = 0.036). Conclusions: Elevated serum CRP levels are associated with endothelial dysfunction, coronary artery calcification and cardiac diastolic dysfunction in chronic cocaine users. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.