Smoking, alcohol and opioids effect on coronary microcirculation: an update overview

• Published in: BMC cardiovascular disorders 2021-04, Vol.21 (1), p.185-17, Article 185
• Main Authors: Jalali, Zahra, Khademalhosseini, Morteza, Soltani, Narjes, Esmaeili Nadimi, Ali
• Format: Article
• Language: English
• Subjects: Alcohol; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Alcohol use; Alcoholism; Analgesics, Opioid - adverse effects; Angina pectoris; Angioplasty; Animals; Carbon monoxide; Cardiomyopathy; Cardiovascular diseases; Cigarettes; Complications and side effects; Coronary artery; Coronary Circulation - drug effects; Coronary microvascular dysfunction; Drinking behavior; Drug abuse; Endothelium; Health aspects; Heart diseases; Humans; Inflammation; Ischemia; Ischemic heart disease; Literature reviews; Medical imaging; Microcirculation - drug effects; Microcirculation disorders; Microvasculature; Mortality; Myocardial infarction; Myocardial Ischemia - diagnosis; Myocardial Ischemia - epidemiology; Myocardial Ischemia - metabolism; Myocardial Ischemia - physiopathology; Myocardium - metabolism; Myocardium - pathology; Narcotics; Nicotine; Opioid; Opioid-Related Disorders - epidemiology; Opioids; Oxidative stress; Review; Risk Assessment; Risk Factors; Smoking; Smoking - adverse effects; Smoking - epidemiology; Smoking cessation
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-01990-y

Smoking, heavy alcohol drinking and drug abuse are detrimental lifestyle factors leading to loss of million years of healthy life annually. One of the major health complications caused by these substances is the development of cardiovascular diseases (CVD), which accounts for a significant proportion of substance-induced death. Smoking and excessive alcohol consumption are related to the higher risk of acute myocardial infarction. Similarly, opioid addiction, as one of the most commonly used substances worldwide, is associated with cardiac events such as ischemia and myocardial infarction (MI). As supported by many studies, coronary artery disease (CAD) is considered as a major cause for substance-induced cardiac events. Nonetheless, over the last three decades, a growing body of evidence indicates that a significant proportion of substance-induced cardiac ischemia or MI cases, do not manifest any signs of CAD. In the absence of CAD, the coronary microvascular dysfunction is believed to be the main underlying reason for CVD. To date, comprehensive literature reviews have been published on the clinicopathology of CAD caused by smoking and opioids, as well as macrovascular pathological features of the alcoholic cardiomyopathy. However, to the best of our knowledge there is no review article about the impact of these substances on the coronary microvascular network. Therefore, the present review will focus on the current understanding of the pathophysiological alterations in the coronary microcirculation triggered by smoking, alcohol and opioids.