# Atherosclerosis in cocaine addiction: imaging risk with PET/MR

> **NIH DA R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2026 · $749,074

## Abstract

Cocaine use disorder (CUD) can cause vascular disease mainly through chronic vasoconstriction effects.
Atherosclerosis can be present in the carotid artery (CA) even without overt clinical symptoms. Once symptoms are
observable, the artery is usually damaged and cerebral ischemia can ensue, a common fatal outcome in CUD.
Indeed, while there are postmortem studies documenting arterial disease in individuals with CUD (iCUD), studies for
early in-vivo detection lag behind with catastrophic consequences. Here we will leverage the significant advances
made in imaging for early detection of atherosclerosis in asymptomatic populations who are nevertheless at
increased risk for vascular disease by MPI Fayad; such early detection is crucial for guiding prevention efforts.
Specifically, we will use a hybrid scanner whereby positron emission tomography (PET) with the radiotracer 18F-
fluorodeoxyglucose (18F-FDG) quantifies vessel-wall inflammation in atherosclerotic plaques while magnetic
resonance imaging (MRI) with a 3-dimensional (3D) dark-blood scan characterizes carotid plaque burden. Such
simultaneous state-of-the-art previously validated PET/MRI CA imaging has never before been applied for early
atherosclerosis detection in asymptomatic drug addicted individuals. Targeting this population for early detection is
of particular urgency now that the “Crack generation” (of the mid 80s) is aging. Following decades of cocaine and
comorbid tobacco and alcohol use, these iCUD are at an especially high risk for vascular disease and
atherosclerosis. Nevertheless, given factors inherent to drug addiction, relevant diagnoses in this population are only
made when it is too late to intervene (hence the preponderance of post-mortem studies). We hypothesize that
markers of CA atherosclerosis will be detected in asymptomatic iCUD, as related to their cocaine, tobacco, and
alcohol use, at levels comparable, or even surpassing, those detected in individuals with known risk factors for
card

## Key facts

- **NIH application ID:** 11304519
- **Project number:** 5R01DA049547-05
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Nelly  Alia-Klein; Zahi A. Fayad; Rita Z Goldstein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** DA
- **Fiscal year:** 2026
- **Award amount:** $749,074
- **Award type:** 5
- **Project period:** 2022-06-01T00:00:00 → 2027-03-31T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11304519

## Citation

> US National Institutes of Health, RePORTER application 11304519, Atherosclerosis in cocaine addiction: imaging risk with PET/MR (5R01DA049547-05). Retrieved via AI Analytics 2026-07-03 from https://api.ai-analytics.org/grant/nih/11304519. Licensed CC0.

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