In-hospital prognosis of acute ST-elevation myocardial infarction in patients with recent recreational drug use.
Eur Heart J Acute Cardiovasc Care
; 13(4): 324-332, 2024 May 07.
Article
en En
| MEDLINE
| ID: mdl-38381068
ABSTRACT
AIMS:
Although recreational drug use may induce ST-elevated myocardial infarction (STEMI), its prevalence in patients hospitalized in intensive cardiac care units (ICCUs), as well as its short-term cardiovascular consequences, remains unknown. We aimed to assess the in-hospital prognosis of STEMI in patients with recreational drug use from the ADDICT-ICCU study. METHODS ANDRESULTS:
From 7-22 April 2021, recreational drug use was detected prospectively by a systematic urine multidrug test in all consecutive patients admitted for STEMI in 39 ICCUs across France. The primary endpoint was major adverse cardiac events (MACEs) defined by death, resuscitated cardiac arrest, or cardiogenic shock. Among the 325 patients (age 62 ± 13 years, 79% men), 41 (12.6%) had a positive multidrug test (cannabis 11.1%, opioids 4.6%, cocaine 1.2%, 3,4-methylenedioxymethamphetamine 0.6%). The prevalence increased to 34.0% in patients under 50 years of age. Recreational drug users were more frequently men (93% vs. 77%, p = 0.02), younger (50 ± 12 years vs. 63 ± 13 years, P < 0.001), and more active smokers (78% vs. 34%, P < 0.001). During hospitalization, 17 MACEs occurred (5.2%), including 6 deaths (1.8%), 10 cardiogenic shocks (3.1%), and 7 resuscitated cardiac arrests (2.2%). Major adverse cardiac events (17.1% vs. 3.5%, P < 0.001) and ventricular arrhythmia (9.8% vs. 1.4%, P = 0.01) were more frequent in recreational drug users. Use of recreational drugs was associated with more MACEs after adjustment for comorbidities (odds ratio = 13.1; 95% confidence interval 3.4-54.6).CONCLUSION:
In patients with STEMI, recreational drug use is prevalent, especially in patients under 50 years of age, and is independently associated with an increase of MACEs with more ventricular arrhythmia. TRIAL REGISTRATION URL https//clinicaltrials.gov/ct2/show/NCT05063097.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infarto del Miocardio con Elevación del ST
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur Heart J Acute Cardiovasc Care
Año:
2024
Tipo del documento:
Article
País de afiliación:
Francia