Recreational drug use elevates chance of repeat serious heart-related event
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Key takeaways:
- Among patients admitted to the cardiac ICU, those engaging in recreational drug use were more likely to have a CV event within 1 year.
- Cannabis, opioid and MDMA use were most strongly tied to CV event risk.
Among patients admitted to the cardiac ICU, those engaging in recreational drug use were almost three times as likely to experience a repeat serious CV event within 1 year compared with nonusers, researchers reported.
“Among patients admitted to the intensive cardiac care unit (ICCU), systematic screening for recreational drugs evidenced a significant prevalence — 11% — of recent use,” Raphaël Mirailles, MD, from Hospital Lariboisiere, Paris, who presented the findings at the European Society of Cardiology Congress, said in a press release. “Recreational drug use was associated with triple the risk of a repeat serious cardiovascular event within 1 year.”
The researchers analyzed 1,392 consecutive patients who presented to the ICCU at 39 centers in France over a 2-week period in April 2021. Those who died during hospitalization, had a planned interventional procedure or went to the ICCU more than 24 hours after admission were excluded.
All patients were screened for recreational drug use and 11% tested positive. The primary outcome was major adverse cardiac or cerebrovascular events at 1 year, stratified by recreational drug use and adjusted for age, sex, diabetes, current smoking status, history of CVD before hospitalization, known chronic kidney disease, history of cancer, the main admission diagnosis, baseline systolic BP and baseline heart rate.
At 1 year, 13% of patients in the drug-use group had a MACCE compared with 6% of nonusers (adjusted HR = 2.99; 95% CI, 1.73-5.16; P < .001), and the difference was driven by nonfatal MI (5.1% vs. 1.3%), according to the researchers.
In a subgroup analysis of 713 patients who had ACS at the index hospitalization (13.5% of whom tested positive for recreational drug use), the elevated risk among drug users for subsequent MACCE was similar (HR = 2.98; 95% CI, 1.43-6.21; P = .004), Mirailles and colleagues found.
Among specific drugs, use of cannabis, opioids and MDMA were all associated with elevated risk for MACCE at 1 year, according to the researchers.
“There is an increasing amount of data regarding worse prognosis associated with recreational drug use, not only in cardiac intensive care units but also in conventional intensive care units,” Mirailles said in the release. “Despite a high rate of underreporting of recreational drug use, systematic screening is not recommended by the current guidelines. It might improve risk stratification of patients and personalized care to favor drug withdrawal. Therefore, systemic screening should be considered in intensive care.”
Reference:
- Recent recreational drug use triples risk of repeat serious cardiovascular event. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Recent-recreational-drug-use-triples-risk-of-repeat-serious-cardiovascular-event. Published Aug. 28, 2024. Accessed Aug. 29, 2024.
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Mirailles R, et al. The best acute cardiovascular-care science. Presented at: European Society of Cardiology Congress; Aug. 30-Sept. 2, 2024; London (hybrid meeting).
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