Recent Recreational Drug Use Ups Risk of Repeat Serious CV Event: Daily Dose

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On August 30, 2024, we reported on a study abstract presented at the European Society of Cardiology (ESC) 2024 Congress that examined long-term cardiovascular consequences of recreational drug use.

The study

Using participant data from the ADDICT-ICCU study, investigators analyzed 1392 consecutive patients who presented to the ICCU at 39 centers in France over a 2-week period in April 2021. All participants were screened for recreational drug use via systematic urinary testing and completed 1-year follow-up that consisted of a clinical visit or direct contact with the patient and the referring cardiologist. The primary outcome was the occurrence of one of the combined MACCE (ie, cardiovascular death, nonfatal myocardial infarction, or stroke).

Among the cohort, 11% (n=157) had an initial positive test for recreational drug use, among which 9.8% tested positive for cannabis, 2.3% for heroin and other opioids, 1.7% for cocaine, 0.6% for amphetamines, and 0.6% for MDMA. In addition, 28.7% of patients tested positive for 2 or more recreational drugs.

The findings

Overall, after 1 year of follow-up, 7% (n=94) of the cohort experienced MACCE, with those testing positive for recreational drug use facing a higher rate than nonusers (13% vs 6%, respectively).

After researchers adjusted for factors (eg, age, sex, smoking status) they observed that recreational drug use was independently associated with the occurrence of MACCE (HR 2.99, 95% CI 1.73-5.16; P < .001).

The following recreational drugs were significantly associated with MACCE:

• MDMA (4.1-times increased risk)

• Heroin/other opioids (3.6-times increased risk)

• Cannabis (1.8-times increased risk)

Authors' comment

“Despite 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.”

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