Psychoactive drug use and prognosis in patients with cancer presenting with acute cardiovascular disease.
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Jaëck Maxime, El Bèze Nathan, Dillinger Jean-Guillaume, Trimaille Antonin, Chaussade Anne Solène, Thuaire Christophe, Delmas Clément, Boccara Albert, Roule Vincent, Millischer Damien, Thevenet Eugénie, Meune Christophe, Stevenard Mathilde, Maitre Ballesteros Laura, Grinberg Nissim, Gonçalves Trecy, Baudet Mathilde, El Ouahidi Amine, Swedsky Fédérico, Lattuca Benoit, Hauguel-Moreau Marie, Schurtz Guillaume, Dupasquier Valentin, Bochaton Thomas, Puymirat Etienne, Toupin Solenn, Henry Patrick, Pezel Théo, Charbonnel Clément, ADDICT-ICCU investigators
Аннотация
AIMS: To assess the prevalence of psychoactive drug use, in-hospital outcomes and 1-year prognosis in patients with cancer hospitalized for acute cardiovascular events.
METHODS: In a prospective multicentre study of all consecutive patients admitted to intensive cardiac care units, a history of cancer was recorded systematically. The primary outcome was the prevalence of psychoactive drugs detected by urine drug assay. The secondary outcomes were: the rate of in-hospital major adverse events, defined as all-cause death, cardiogenic shock and cardiac arrest; and the 1-year rate of major adverse cardiovascular and cerebrovascular events, defined as cardiovascular death, myocardial infarction and stroke.
RESULTS: Among 1499 patients recruited, 151 had a history of cancer (10%), including 61 (40%) with active cancer and 90 (60%) with cancer in remission. Among patients with a history of cancer, 39 (25.8%) tested positive for at least one psychoactive drug. Using a matching approach based on the likelihood of having a cancer, a history of cancer was not associated with an increased risk of in-hospital major adverse events (odds ratio: 1.54, 95% confidence interval: 0.68-3.45; P=0.3). However, a history of cancer was associated with a higher incidence of 1-year major adverse cardiovascular and cerebrovascular events (hazard ratio: 3.04, 95% confidence interval: 1.63-5.67; P<0.001).
CONCLUSIONS: The prevalence of psychoactive drug use among patients with a history of cancer hospitalized for acute cardiovascular events was 25.8%. A history of cancer was an independent predictor of 1-year major adverse cardiovascular and cerebrovascular events.