Among patients hospitalized in intensive care units, those with a recent history of recreational drug use have triple the risk of repeat cardiovascular events within one year compared to those with no history of use, a recent study revealed.

The latest study explored how recent recreational drug use affects the risk of serious cardiovascular events, including death, over a year in nearly 1,400 patients admitted to ICUs across France. The results were presented at this year's ESC Congress 2024 in London.

The participants were patients admitted to intensive care units for acute cardiovascular issues as part of the ADDICT-ICCU study. Through systematic urinary tests, the researchers conducted screening for recreational drug use in all patients who provided written consent for the procedure. The drugs tested for 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 looked for the occurrence of serious cardiac events as a primary outcome, including cardiovascular death, non-fatal heart attack, or stroke. Further, a subgroup analysis was done on patients hospitalized for acute coronary syndrome, such as non-fatal heart attacks or prolonged angina lasting more than 20 minutes.

At the end of the follow-up, 7% of patients experienced a serious cardiovascular event, including death. "Patients with positive testing exhibited a higher rate of serious cardiovascular events than non-users (13% vs 6%, respectively, a statistically significant finding)," the news release stated.

After adjusting for factors such as age, sex, diabetes, current smoking status, previous cardiovascular disease, chronic kidney disease, cancer history, primary diagnosis at admission, baseline systolic blood pressure, and heart rate, recreational drug use was found to be independently linked to a threefold higher risk of serious cardiovascular events.

"Among patients admitted to the intensive cardiac care unit (ICCU), systematic screening for recreational drugs evidenced a significant prevalence – 11% - of recent use. Recreational drug use was associated with triple the risk of a repeat serious cardiovascular event within one year," said study author Dr Raphael Mirailles, Hospital Lariboisiere, Paris, France, in the news release.

"There is an increasing amount of data regarding the worst prognosis associated with recreational drug use, not only in cardiac intensive care units but also in conventional intensive care units. 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," Dr Mirailles added.

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