Prevalence and impact of recreational drug use in patients with acute cardiovascular events.
acute coronary syndrome
drug interactions
outcome assessment, health care
Journal
Heart (British Cardiac Society)
ISSN: 1468-201X
Titre abrégé: Heart
Pays: England
ID NLM: 9602087
Informations de publication
Date de publication:
12 Oct 2023
12 Oct 2023
Historique:
received:
10
02
2023
accepted:
26
04
2023
pubmed:
16
8
2023
medline:
16
8
2023
entrez:
15
8
2023
Statut:
epublish
Résumé
While recreational drug use is a risk factor for cardiovascular events, its exact prevalence and prognostic impact in patients admitted for these events are not established. We aimed to assess the prevalence of recreational drug use and its association with in-hospital major adverse events (MAEs) in patients admitted to intensive cardiac care units (ICCU). In the Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study, systematic screening for recreational drugs was performed by prospective urinary testing all patients admitted to ICCU in 39 French centres from 7 to 22 April 2021. The primary outcome was prevalence of recreational drug detection. In-hospital MAEs were defined by death, resuscitated cardiac arrest, or haemodynamic shock. Of 1499 consecutive patients (63±15 years, 70% male), 161 (11%) had a positive test for recreational drugs (cannabis 9.1%, opioids 2.1%, cocaine 1.7%, amphetamines 0.7%, 3,4-methylenedioxymethamphetamine (MDMA) 0.6%). Only 57% of these patients declared recreational drug use. Patients who used recreational drugs exhibited a higher MAE rate than others (13% vs 3%, respectively, p<0.001). Recreational drugs were associated with a higher rate of in-hospital MAEs after adjustment for comorbidities (OR 8.84, 95% CI 4.68 to 16.7, p<0.001). After adjustment, cannabis, cocaine, and MDMA, assessed separately, were independently associated with in-hospital MAEs. Multiple drug detection was frequent (28% of positive patients) and associated with an even higher incidence of MAEs (OR 12.7, 95% CI 4.80 to 35.6, p<0.001). The prevalence of recreational drug use in patients hospitalised in ICCU was 11%. Recreational drug detection was independently associated with worse in-hospital outcomes. NCT05063097.
Identifiants
pubmed: 37582633
pii: heartjnl-2023-322520
doi: 10.1136/heartjnl-2023-322520
doi:
Banques de données
ClinicalTrials.gov
['NCT05063097']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1608-1616Investigateurs
Emeric Albert
(E)
Franck Albert
(F)
Sean Alvain
(S)
Nabil Amri
(N)
Sabir Attou
(S)
Simon Auvray
(S)
Sonia Azzakani
(S)
Ruben Azencot
(R)
Marc Bedossa
(M)
Franck Boccara
(F)
Albert Boccara
(A)
Eric Bonnefoy-Cudraz
(E)
Nabil Bouali
(N)
Océane Bouchot
(O)
Tanissia Boukertouta
(T)
Jean Baptiste Brette
(JB)
Marjorie Canu
(M)
Aures Chaib
(A)
Clement Charbonnel
(C)
Anne Solene Chaussade
(AS)
Alexandre Coppens
(A)
Yves Cottin
(Y)
Arthur Darmon
(A)
Elena De Angelis
(E)
Laura Delsarte
(L)
Jean Claude Dib
(JC)
Valentin Dupasquier
(V)
Antony El Hadad
(AE)
Nacim Ezzouhairi
(N)
Julien Fabre
(J)
Édouard Gerbaud
(É)
Martine Gilard
(M)
Nissim Grinberg
(N)
Alain Grentzinger
(A)
Marie Hauguel-Moreau
(M)
Fabien Huet
(F)
Thomas Landemaine
(T)
Léo Lemarchand
(L)
Thomas Levasseur
(T)
Pascal Lim
(P)
Laura Maitre Ballesteros
(LM)
Nicolas Mansencal
(N)
Benjamin Marie
(B)
David Martinez
(D)
Benoit Merat
(B)
Christophe Meune
(C)
Damien Millischer
(D)
Thomas Moine
(T)
Pascal Nhan
(P)
Patrick Ohlmann
(P)
Fabien Picard
(F)
Arthur Ramonatxo
(A)
Vincent Roule
(V)
Mathilde Stevenard
(M)
David Sulman
(D)
Fédérico Swedsky
(F)
Victoria Tea
(V)
Eugénie Thevenet
(E)
Christophe Thuaire
(C)
Christophe Tron
(C)
Guillaume Viboud
(G)
Dominique Yomi
(D)
Cyril Zakine
(C)
Informations de copyright
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.