Recreational drug use significantly elevates the risk of recurrent cardiovascular events, according to research presented at the European Society of Cardiology Congress 2024 in London. The study found that individuals who use recreational drugs face a tripled risk of experiencing a major adverse cardiovascular or cerebrovascular event (MACCE) within one year following hospitalization.
The research, led by Dr. Raphaël Mirailles from Hospital Lariboisiere in Paris, involved an analysis of 1,392 patients admitted to intensive cardiac care units across 39 French centers. Participants were followed for one year to assess the prognostic impact of recreational drug use on cardiovascular outcomes.
Prevalence and Impact of Specific Substances
The study revealed that 11% of patients tested positive for recreational drug use upon initial screening. Cannabis was the most prevalent substance, detected in 9.8% of patients, followed by heroin and other opioids (2.3%), cocaine (1.7%), amphetamines (0.6%), and 3,4-methylenedioxymethamphetamine (MDMA) at 0.6%. Notably, over a quarter (28.7%) of those testing positive had used two or more drugs.
At the one-year follow-up, 7% of all patients experienced a MACCE. However, the incidence was significantly higher among patients who tested positive for drug use compared to non-users (13% versus 6%). After adjusting for factors such as age, sex, diabetes, smoking status, and prior cardiovascular disease, the risk of MACCE was tripled in drug users. Specific substances showed significant associations with increased risk: MDMA (4.1 times increased risk), heroin and other opioids (3.6 times), and cannabis (1.8 times).
Implications for Clinical Practice
Dr. Mirailles emphasized the potential benefits of systematic screening for recreational drug use in intensive care settings, despite its current lack of recommendation in guidelines. "It might improve risk stratification of patients and personalized care to favor drug withdrawal. Therefore, systemic screening should be considered in intensive care."
The findings underscore the importance of considering recreational drug use as a significant risk factor for adverse cardiovascular outcomes and highlight the need for improved screening and intervention strategies in clinical practice.
