Recent recreational drug apply in ICU patients triples risk of recurrent cardiovascular events: study

Patients hospitalized in intensive care units are three times more likely to have recurrent cardiovascular events within a year than those without a history of drug apply, a novel study has found.

The latest study examined how recent recreational drug apply affected the risk of major cardiovascular events, including death, over a year in almost 1,400 patients admitted to intensive care units in France. The results were presented at this year’s ESC Congress 2024 in London.

Participants were patients admitted to intensive care units for acute cardiovascular problems as part of the ADDICT-ICCU study. Through systematic urine testing, researchers screened for recreational drug apply in all patients who provided written informed consent. Drugs screened included cannabis, opioids, cocaine, amphetamines, 3,4-methylenedioxymethamphetamine [MDMA]Over a year, follow-up included clinical visits or direct contact with patients and their referring cardiologists.

The study was designed to examine the occurrence of major cardiac events as the primary outcome, including cardiovascular death, nonfatal heart attack, or stroke. In addition, a subgroup analysis was performed for patients hospitalized with an acute coronary syndrome, such as nonfatal heart attack or prolonged angina lasting more than 20 minutes.

At the end of the follow-up period, 7% of patients had a major cardiovascular event, including death. “Patients with a positive test result had a higher rate of major cardiovascular events than non-users (13% vs. 6%, statistically significant)” press release it was stated.

After adjusting for factors such as age, sex, diabetes, current smoking status, history of cardiovascular disease, chronic kidney disease, history of cancer, initial diagnosis at admission, baseline systolic blood pressure, and heart rate, recreational drug apply was independently associated with a three-fold increased risk of major cardiovascular events.

“Among patients admitted to the cardiac intensive care unit (ICCU), systematic screening for recreational drugs revealed a significant prevalence of recent apply (11%). Recreational drug apply was associated with a three-fold increased risk of a recurrent major cardiovascular event within one year,” said study author Dr. Raphael Mirailles, of Lariboisiere Hospital in Paris, France, in a press release.

“There is increasing evidence of the worst-case prognosis associated with recreational drug apply, not only in cardiac intensive care units but also in conventional intensive care units. Despite the high rate of underestimation of recreational drug apply, systematic screening is not recommended by current guidelines. It could improve risk stratification of patients and personalized care to promote drug withdrawal. Therefore, systematic screening in intensive care should be considered,” added Dr. Mirailles.