In-hospital prognosis of acute ST-elevation myocardial infarction in patients with recent recreational drug use.

Autor:	Clement A; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Dillinger JG; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Ramonatxo A; Department of Cardiology, University Hospital of Poitiers, 86000 Poitiers, France., Roule V; Department of Cardiology, Caen University Hospital, 14000 Caen, France., Picard F; Service de Cardiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France., Thevenet E; Department of Cardiology, University Hospital of Martinique, 97261 Fort-de-France, France., Swedzky F; Service de cardiologie, Hôpital Henri Duffaut, 84902 Avignon, France., Hauguel-Moreau M; Université de Versailles-Saint Quentin, INSERM U1018, CESP, ACTION Study Group, Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France., Sulman D; Université de Paris, Department of Cardiology, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France., Stevenard M; Service de cardiologie et médecine aéronautique, Hôpital d'Instruction des Armées Percy, 92140 Clamart, France., Amri N; Service de Cardiologie Interventionnelle, CHU Timone, APHM, Aix Marseille Univ, Marseille, France., Martinez D; Department of Cardiology, Nîmes University Hospital, Montpellier University, Nîmes, France., Maitre-Ballesteros L; Service de Cardiologie, CHU Grenoble-Alpes, 38043 Grenoble cedex 09, France., Landemaine T; Unité de Soins intensifs Cardiologiques, CHU Amiens, 80000 Amiens, France., Coppens A; Department of Cardiology, Andre Gregoire Hospital, 93100 Montreuil, France., Bouali N; Department of Cardiology, University Hospital of Poitiers, 86000 Poitiers, France.; Service de Cardiologie, Centre hospitalier de Saintonge, 17100 Saintes, France., Guiraud-Chaumeil P; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Gall E; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Lequipar A; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Henry P; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France., Pezel T; Université Paris Cité, Department of Cardiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Inserm U-942, 2 Rue Ambroise Paré, 75010 Paris, France.
Jazyk:	angličtina
Zdroj:	European heart journal. Acute cardiovascular care [Eur Heart J Acute Cardiovasc Care] 2024 May 07; Vol. 13 (4), pp. 324-332.
DOI:	10.1093/ehjacc/zuae024
Abstrakt:	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 and Results: 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. Competing Interests: Conflict of interest: none declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu