Effects of polydrug use, adulterants and HIV on cardiac injury in homeless women

多种药物使用、掺假物和艾滋病毒对无家可归妇女心脏损伤的影响

基本信息

批准号：
9307757
负责人：
ELISE D. RILEY
金额：
$ 80.88万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9307757
关键词：
AIDS/HIV problem Acute Address Age Alcohols Autopsy Behavior Therapy Biological Assay Biological Markers Breathing Caffeine Cardiac Cardiac health Cardiovascular system Case Study Cause of Death Cessation of life Chest Pain Chronic Chronic Disease Clinical Clothing Cocaine Cocaine Users Cohort Studies Communities Comorbidity Coronary heart disease Cross-Sectional Studies Data Death Rate Development Drug abuse Drug toxicity Drug usage Drug user Echocardiography Event Food Frequencies Future Goals Gold Guidelines HIV HIV Infections Hair Health Health Care Visit Healthcare Heart Homelessness Hygiene Immune Individual Infarction Injury Interruption Interview Intoxication Legal Levamisole Link Measures Medical Medical Examiners Morbidity - disease rate Myocardial Myocardial Infarction Myocardial dysfunction Nicotine Outcome Overdose Persons Pharmaceutical Preparations Pharmacology Population Prevalence Race Recruitment Activity Reporting Risk Risk Assessment Risk stratification Role San Francisco Seizures Shelter facility Specimen Sudden Death Surveys Symptoms Time Tobacco Toxic effect Toxicology Troponin Troponin I Ventricular Dysfunction Vulnerable Populations Woman antiretroviral therapy cardiovascular health cardiovascular risk factor cocaine use cohort drug use vulnerability effective therapy follow-up housing instability illicit drug use mortality multidisciplinary overdose death public health relevance response social standard measure sudden cardiac death tool trend

项目摘要

DESCRIPTION (provided by applicant): Observations from a recently completed homeless women's cohort study indicated that acute intoxication in which cocaine was detected at autopsy was the most common cause of death. This finding follows a national trend of increased overdose deaths. According to the San Francisco Medical Examiner, at least one-third of cocaine-related deaths among San Francisco women are directly linked to a cardiovascular event. While independent influences of both cocaine use and HIV infection on cardiac dysfunction have been described, combined effects and influences from polysubstance use are unclear. Such information could be used to address subclinical cardiac dysfunction prior to infarction and sudden death. Here we propose a multi- disciplinary study to understand the circumstances preceding acute drug-induced cardiovascular events among homeless women. We hypothesize that HIV, polysubstance use and concomitant medications influence chronic drug toxicity and subclinical cardiac injury. To meet our aims, the study will obtain interview data, echocardiograms and specimens for biomarker assessment among 250 homeless and unstably housed women (125 HIV+ and 125 HIV-). Results from the proposed study will provide enhanced clinical tools for risk assessment and risk stratification among cocaine users, as well as clarify endpoints for future pharmacological and behavioral interventions.

描述（由申请人提供）：来自最近完成的无家可归妇女队列研究的观察结果表明，在尸检时检测到可卡因的急性中毒是最常见的死亡原因。这一发现是在全国范围内的过量死亡人数增加的趋势之后。据旧金山医学检查官称，旧金山妇女中至少有三分之一的可卡因相关死亡与心血管事件直接相关。虽然已经描述了可卡因使用和HIV感染对心脏功能障碍的独立影响，但尚不清楚多进化的综合作用和影响。这些信息可用于在梗塞和猝死之前解决亚临床心脏功能障碍。在这里，我们提出了一项多学科研究，以了解无家可归妇女急性药物引起的心血管事件之前的情况。我们假设艾滋病毒，多物质使用和随之而来的药物会影响慢性药物毒性和亚临床心脏损伤。为了满足我们的目标，该研究将获得250名无家可归者和不稳定的妇女（125 HIV+和125 HIV-）的生物标志物评估的访谈数据，超声心动图和标本。拟议研究的结果将为可卡因使用者之间的风险评估和风险分层提供增强的临床工具，并阐明未来药理和行为干预措施的终点。