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Citation
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Trytell A, Osekowski M, Zentner D, Nehme Z, James P, Pflaumer A, Semsarian C, Ingles J, Stub D, La Gerche A, Paratz ED. Heart Rhythm 2023; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Illicit drug use may accelerate coronary disease and cardiac hypertrophy or stimulate arrhythmias. Rates of illicit drug use in young sudden cardiac death (SCD) patients are uncertain.
OBJECTIVE: To identify rates of illicit drug use in young SCD patients.
METHODS: A prospective state-wide registry identified out of hospital cardiac arrest (OHCA) patients aged 18-50 years from April 2019 to April 2021. Clinical characteristics were compared between patients with and without illicit drug use (defined by toxicological results or reported regular use). Illicit drugs included amphetamine-type substances, cocaine, heroin, cannabis and other drugs.
RESULTS: 554/1,378 patients had confirmed cardiac cause of OHCA with 523 undergoing toxicological assessment. There were 170 patients (32.5%) having either positive toxicology for illicit drugs (n=138) or negative toxicology but reported regular drug use (n=32). Patients with SCD and illicit drug use were more commonly male (81.2% vs 72.3%, p=0.028), smokers (38.8% vs 19.8%, p=<0.0001), excess alcohol drinkers (30.6% vs 20.6%, p=0.012), had a psychiatric diagnosis (38.8% vs 25.7%, p=0.002), lower BMI (29.4kg/m(2) vs 31.7kg/m(2), p=0.0063) and lower rates of hypertension (10.6% vs 18.6%, p=0.019). Death commonly occurred while sedentary (47.5%) or during sleep (45.8%). Accounting for these baseline differences, there were no differences in rates of coronary disease or cardiomyopathy. Cannabis (n=106) was the most common illicit drug identified and polysubstance abuse occurred frequently (n=25).
CONCLUSION: Approximately one-third of young SCD patients have positive toxicology at the time of death or reported frequent use of illicit drugs, with high rates of polysubstance abuse.
Language: en |