PMID- 37582633
OWN - NLM
STAT- Publisher
LR  - 20231012
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 109
IP  - 21
DP  - 2023 Oct 12
TI  - Prevalence and impact of recreational drug use in patients with acute 
      cardiovascular events.
PG  - 1608-1616
LID - 10.1136/heartjnl-2023-322520 [doi]
AB  - OBJECTIVE: While recreational drug use is a risk factor for cardiovascular 
      events, its exact prevalence and prognostic impact in patients admitted for these 
      events are not established. We aimed to assess the prevalence of recreational 
      drug use and its association with in-hospital major adverse events (MAEs) in 
      patients admitted to intensive cardiac care units (ICCU). METHODS: In the 
      Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study, systematic 
      screening for recreational drugs was performed by prospective urinary testing all 
      patients admitted to ICCU in 39 French centres from 7 to 22 April 2021. The 
      primary outcome was prevalence of recreational drug detection. In-hospital MAEs 
      were defined by death, resuscitated cardiac arrest, or haemodynamic shock. 
      RESULTS: Of 1499 consecutive patients (63+/-15 years, 70% male), 161 (11%) had a 
      positive test for recreational drugs (cannabis 9.1%, opioids 2.1%, cocaine 1.7%, 
      amphetamines 0.7%, 3,4-methylenedioxymethamphetamine (MDMA) 0.6%). Only 57% of 
      these patients declared recreational drug use. Patients who used recreational 
      drugs exhibited a higher MAE rate than others (13% vs 3%, respectively, p<0.001). 
      Recreational drugs were associated with a higher rate of in-hospital MAEs after 
      adjustment for comorbidities (OR 8.84, 95% CI 4.68 to 16.7, p<0.001). After 
      adjustment, cannabis, cocaine, and MDMA, assessed separately, were independently 
      associated with in-hospital MAEs. Multiple drug detection was frequent (28% of 
      positive patients) and associated with an even higher incidence of MAEs (OR 12.7, 
      95% CI 4.80 to 35.6, p<0.001). CONCLUSION: The prevalence of recreational drug 
      use in patients hospitalised in ICCU was 11%. Recreational drug detection was 
      independently associated with worse in-hospital outcomes. CLINICAL TRIAL 
      REGISTRATION: NCT05063097.
CI  - (c) Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Pezel, Theo
AU  - Pezel T
AUID- ORCID: 0000-0002-6716-8444
AD  - Department of Cardiology, Hopital Lariboisiere, Assistance Publique - Hopitaux de 
      Paris, Universite Paris Cite, INSERM U 942, Paris, France.
FAU - Dillinger, Jean-Guillaume
AU  - Dillinger JG
AD  - Department of Cardiology, Hopital Lariboisiere, Assistance Publique - Hopitaux de 
      Paris, Universite Paris Cite, INSERM U 942, Paris, France.
FAU - Trimaille, Antonin
AU  - Trimaille A
AD  - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg 
      University Hospital, Strasbourg, France.
FAU - Delmas, Clement
AU  - Delmas C
AD  - Intensive Cardiac Care Unit, University Hospital of Rangueil, Toulouse, France.
FAU - Piliero, Nicolas
AU  - Piliero N
AUID- ORCID: 0000-0003-3020-6758
AD  - Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
FAU - Bouleti, Claire
AU  - Bouleti C
AUID- ORCID: 0000-0001-6922-0093
AD  - Cardiology, University of Poitiers, Clinical Investigation Center (CIC) INSERM 
      1402, Poitiers University Hospital, Poitiers, France.
FAU - Pommier, Thibaut
AU  - Pommier T
AD  - University Hospital Centre Dijon, Dijon, Bourgogne, France.
FAU - El Ouahidi, Amine
AU  - El Ouahidi A
AD  - Department of Cardiology, University Hospital of Brest, Brest, France.
FAU - Andrieu, Stephane
AU  - Andrieu S
AD  - Hopital Henri Duffaut, Avignon, France.
FAU - Lattuca, Benoit
AU  - Lattuca B
AD  - Cardiology, Centre Hospitalier Universitaire de Nimes, Montpellier University, 
      Nimes, France.
FAU - Rossanaly Vasram, Reza
AU  - Rossanaly Vasram R
AUID- ORCID: 0000-0003-4212-9649
AD  - Department of Cardiology, Felix-Guyon University Hospital, Saint-Denis, France.
FAU - Fard, Damien
AU  - Fard D
AD  - Intensive Cardiac Care Unit, Hopital Henri Mondor, Creteil, France.
FAU - Noirclerc, Nathalie
AU  - Noirclerc N
AD  - Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, Rhone-Alpes, France.
FAU - Bonnet, Guillaume
AU  - Bonnet G
AD  - Assistance Publique Hopitaux de Marseille, Aix Marseille Univ, INSERM, INRAE, 
      C2VN, Marseille, Provence-Alpes-Cote d'Azu, France.
AD  - Unite de Recherche Clinique, Groupe hospitalier Lariboisiere Fernand-Widal, 
      Paris, Ile-de-France, France.
FAU - Goralski, Marc
AU  - Goralski M
AD  - Centre Hospitalier d'Orleans, Orleans, France.
FAU - Elbaz, Meyer
AU  - Elbaz M
AD  - Intensive Cardiac Care Unit, University Hospital of Rangueil, Toulouse, France.
FAU - Deney, Antoine
AU  - Deney A
AD  - University Hospital Centre Toulouse, Toulouse, Midi-Pyrenees, France.
FAU - Schurtz, Guillaume
AU  - Schurtz G
AD  - Cardiology, CHRU Lille, Lille, France.
FAU - Docq, Clemence
AU  - Docq C
AD  - Department of Cardiology, University Hospital of Lille, Lille, France.
FAU - Roubille, Francois
AU  - Roubille F
AD  - Cardiology Department, INI-CRT, CHU de Montpellier, PhyMedExp, Universite de 
      Montpellier, INSERM, CNRS, Montpellier, France.
FAU - Fauvel, Charles
AU  - Fauvel C
AD  - Rouen University Hospital, INSERM EnVI 1096, Rouen, France.
FAU - Bochaton, Thomas
AU  - Bochaton T
AUID- ORCID: 0000-0002-5889-7506
AD  - Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de 
      Lyon, Lyon, France.
FAU - Aboyans, Victor
AU  - Aboyans V
AD  - Department of Cardiology, Dupuytren University Hospital and Inserm 1094, Limoges, 
      France.
FAU - Boccara, Franck
AU  - Boccara F
AUID- ORCID: 0000-0002-6908-9678
AD  - Cardiology, Sorbonne Universite, GRC n degrees 22, C(2)MV, Inserm UMR_S 938, Centre de 
      Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-metabolisme 
      et Nutrition (ICAN), Assistance Publique-Hopitaux de Paris, Hopital Saint Antoine 
      Service de Cardiologie, Paris, France.
FAU - Puymirat, Etienne
AU  - Puymirat E
AD  - Cardiologie, Hopital europeen Georges-Pompidou, Paris, France.
FAU - Batisse, Anne
AU  - Batisse A
AD  - Centre d'evaluation et d'information sur la pharmacodependence de Paris, GH 
      Lariboisiere Fernand-Widal, Paris, Ile-de-France, France.
FAU - Steg, Gabriel
AU  - Steg G
AD  - Cardiology, Universite Paris-Cite, Assistance Publique-Hopitaux de Paris, Hopital 
      Bichat, and Institut Universitaire de France, PARIS, France.
FAU - Vicaut, Eric
AU  - Vicaut E
AD  - Unite de Recherche Clinique, Groupe hospitalier Lariboisiere Fernand-Widal, 
      Paris, Ile-de-France, France.
FAU - Henry, Patrick
AU  - Henry P
AD  - Department of Cardiology, Hopital Lariboisiere, Assistance Publique - Hopitaux de 
      Paris, Universite Paris Cite, INSERM U 942, Paris, France patrick.henry@aphp.fr 
      patrick.henry@aphp.fr.
CN  - ADDICT-ICCU Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT05063097
PT  - Journal Article
DEP - 20231012
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - drug interactions
OT  - outcome assessment, health care
COIS- Competing interests: None declared.
FIR - Albert, Emeric
IR  - Albert E
FIR - Albert, Franck
IR  - Albert F
FIR - Alvain, Sean
IR  - Alvain S
FIR - Amri, Nabil
IR  - Amri N
FIR - Attou, Sabir
IR  - Attou S
FIR - Auvray, Simon
IR  - Auvray S
FIR - Azzakani, Sonia
IR  - Azzakani S
FIR - Azencot, Ruben
IR  - Azencot R
FIR - Bedossa, Marc
IR  - Bedossa M
FIR - Boccara, Franck
IR  - Boccara F
FIR - Boccara, Albert
IR  - Boccara A
FIR - Bonnefoy-Cudraz, Eric
IR  - Bonnefoy-Cudraz E
FIR - Bouali, Nabil
IR  - Bouali N
FIR - Bouchot, Oceane
IR  - Bouchot O
FIR - Boukertouta, Tanissia
IR  - Boukertouta T
FIR - Brette, Jean Baptiste
IR  - Brette JB
FIR - Canu, Marjorie
IR  - Canu M
FIR - Chaib, Aures
IR  - Chaib A
FIR - Charbonnel, Clement
IR  - Charbonnel C
FIR - Chaussade, Anne Solene
IR  - Chaussade AS
FIR - Coppens, Alexandre
IR  - Coppens A
FIR - Cottin, Yves
IR  - Cottin Y
FIR - Darmon, Arthur
IR  - Darmon A
FIR - Angelis, Elena De
IR  - Angelis E
FIR - Delsarte, Laura
IR  - Delsarte L
FIR - Dib, Jean Claude
IR  - Dib JC
FIR - Dupasquier, Valentin
IR  - Dupasquier V
FIR - Hadad, Antony El
IR  - Hadad AE
FIR - Ezzouhairi, Nacim
IR  - Ezzouhairi N
FIR - Fabre, Julien
IR  - Fabre J
FIR - Gerbaud, Edouard
IR  - Gerbaud E
FIR - Gilard, Martine
IR  - Gilard M
FIR - Grinberg, Nissim
IR  - Grinberg N
FIR - Grentzinger, Alain
IR  - Grentzinger A
FIR - Hauguel-Moreau, Marie
IR  - Hauguel-Moreau M
FIR - Huet, Fabien
IR  - Huet F
FIR - Landemaine, Thomas
IR  - Landemaine T
FIR - Lemarchand, Leo
IR  - Lemarchand L
FIR - Levasseur, Thomas
IR  - Levasseur T
FIR - Lim, Pascal
IR  - Lim P
FIR - Ballesteros, Laura Maitre
IR  - Ballesteros LM
FIR - Mansencal, Nicolas
IR  - Mansencal N
FIR - Marie, Benjamin
IR  - Marie B
FIR - Martinez, David
IR  - Martinez D
FIR - Merat, Benoit
IR  - Merat B
FIR - Meune, Christophe
IR  - Meune C
FIR - Millischer, Damien
IR  - Millischer D
FIR - Moine, Thomas
IR  - Moine T
FIR - Nhan, Pascal
IR  - Nhan P
FIR - Ohlmann, Patrick
IR  - Ohlmann P
FIR - Picard, Fabien
IR  - Picard F
FIR - Ramonatxo, Arthur
IR  - Ramonatxo A
FIR - Roule, Vincent
IR  - Roule V
FIR - Stevenard, Mathilde
IR  - Stevenard M
FIR - Sulman, David
IR  - Sulman D
FIR - Swedsky, Federico
IR  - Swedsky F
FIR - Tea, Victoria
IR  - Tea V
FIR - Thevenet, Eugenie
IR  - Thevenet E
FIR - Thuaire, Christophe
IR  - Thuaire C
FIR - Tron, Christophe
IR  - Tron C
FIR - Viboud, Guillaume
IR  - Viboud G
FIR - Yomi, Dominique
IR  - Yomi D
FIR - Zakine, Cyril
IR  - Zakine C
EDAT- 2023/08/16 00:42
MHDA- 2023/08/16 00:42
CRDT- 2023/08/15 21:03
PHST- 2023/02/10 00:00 [received]
PHST- 2023/04/26 00:00 [accepted]
PHST- 2023/08/16 00:42 [pubmed]
PHST- 2023/08/16 00:42 [medline]
PHST- 2023/08/15 21:03 [entrez]
AID - heartjnl-2023-322520 [pii]
AID - 10.1136/heartjnl-2023-322520 [doi]
PST - epublish
SO  - Heart. 2023 Oct 12;109(21):1608-1616. doi: 10.1136/heartjnl-2023-322520.