Recreational drugs detected in 10% of cardiac intensive care patients

Recreational drugs were detected in more than 10 per cent of cardiac intensive care patients in a new study for an international medical journal.

Drug-use was associated with significantly poorer outcomes, the study found, with users nearly nine times as likely to die or require emergency intervention as other heart patients while in hospital, and 12 times as likely to do so if they used more than one drug.

Researchers involved in the study, which was published in the journal Heart, analysed the urine samples of all patients admitted to cardiac intensive care in 39 French hospitals during a two-week period in April 2021, with a view to detecting recreational drug-use.

A total of 1,904 patients were admitted during this period, 1,499 of whom provided a urine sample. The average age was 63 and 70 per cent were male. Of these 161 (11%) tested positive for various recreational drugs, but only just over half (57%) admitted to using. Prevalence was even higher among the under-40s, with one in three testing positive for recreational drugs.

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The most frequently detected substance was cannabis (9%), followed by opioids (2%), cocaine (just under 2%), amphetamines (nearly 1%), and MDMA or ecstasy (just over 0.5%).

Compared with other non-using heart patients, users were more likely to die or to require emergency intervention for events such as cardiac arrest or acute circulatory failure while in hospital.

After adjusting for other underlying conditions, such as HIV, diabetes and high blood pressure, users were nearly nine times as likely to die or require emergency treatment.

The researchers said the study is observational and as such cannot establish that recreational drug-use resulted in admission to cardiac intensive care. The limited data “requires caution in the clinical interpretation of these findings”, they added.

However, they said recreational drugs can increase blood pressure, heart rate, temperature and consequently the heart’s need for oxygen.

“While the current guidelines recommend only a declarative survey to investigate recreational drug-use these findings suggest the potential value of urine screening in selected patients with acute cardiovascular events.”

Prof Jim O’Neill, cardiologist at the Mater Private in Dublin, said that, while he had not had the chance to read the study it was not unusual to see someone admitted to hospital with “severe cardiac difficulties caused by acute or chronic use of cocaine”.

However, Prof O’Neill said the main causes of cardiac issues in people under 40 was smoking, and that while drugs may be a consideration alcohol and nicotine posed a higher risk, saying they were the “most frequent culprits” in the cause of heart disease and conditions.

Prof O’Neill said that the main risk factors around cardiac issues in his experience were lifestyle factors such as diet and exercise levels.