Widespread use of recreational drugs may be contributing to serious cardiovascular illnesses, doctors warn today.
An analysis found that more than one in ten patients in intensive cardiac care units have physical evidence of recent recreational drug consumption.
It is known that recreational drugs can cause a range of acute cardiovascular events, and that recent use of cannabis or cocaine is linked to worse long term outcomes after a heart attack, according to the researchers.
Now, Dr Theo Pezel of INSERM, Paris, France, and colleagues set out to measure the exact rate of recreational drug use in heart patients, and its impact on ‘in-hospital major adverse events’.
These events included death, a cardiac arrest requiring resuscitation, or haemodynamic shock.
The team recruited 1,499 patients admitted to 39 French intensive cardiac care units during April 2021, and gave them urine drug tests.
Urine tests showed that 11% had a positive test for cannabis, opioids, cocaine, amphetamines or MDMA. Among these patients, only 57% declared their recreational drug use to medical staff.
The use of recreational drugs was linked to a major adverse event rate of 13%, compared with 3% for those who tested negative.
Once comorbidities were taken into account, recreational drug use was linked to nearly nine times more in-hospital major adverse events. Each drug, when looked at separately, was linked to a higher risk.
In Heart today, the authors write: “This study is the first to describe an independent prognostic impact of recreational drugs on the occurrence of intra-hospital outcomes in patients with an acute cardiovascular event.”
They explain that recreational drugs can increase blood pressure, heart rate, temperature, and consequently the heart’s need for oxygen.
“These findings suggest the potential value of urine screening in selected patients with acute cardiovascular events to improve risk stratification,” they add.
Pezel, T. et al. Prevalence and impact of recreational drug use in patients with acute cardiovascular events. Heart 16 August 2023; doi: 10.1136/heartjnl-2023-322520
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