International journal of public health · 2015
Cardiovascular disease among people with drug use disorders.
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Thylstrup Birgitte, Clausen Thomas, Hesse Morten
Аннотация
OBJECTIVES: To present the prevalence and incidence of cardiovascular disease (CVD) in a national cohort of patients seeking treatment for drug use disorders (DUD).
METHODS: This is a longitudinal record linkage study of consecutive DUD treatment admissions between 2000 and 2006 from Denmark.
RESULTS: Of 17,642 patients seeking treatment for DUD, 828 individuals (4.53%) had a history of CVD at treatment entry. Among the remaining patients, 16,820 were traced and 1535 new incident cases of CVD were observed during a mean follow-up time of 7.5 years. The incidence of CVD was associated with intravenous drug use [subhazard ratio (SHR) = 1.41, p < 0.001], not responding to injection question (SHR = 1.23, p = 0.005), older age (SHR = 1.04 per year, p = 0.000), use of prescription methadone (SHR = 1.32, p < 0.001), use of benzodiazepines (SHR = 1.21, p = 0.005), and being referred to methadone treatment (SHR = 1.15, p = 0.022). The use of amphetamines was negatively associated with the risk of CVD within this cohort (SHR = 0.75, p = 0.001).
CONCLUSIONS: Patients injecting drugs using prescribed methadone were at elevated risk for cardiovascular disease and should be monitored for CVD. Opioid medications should be evaluated in terms of their cardiovascular sequelae.
METHODS: This is a longitudinal record linkage study of consecutive DUD treatment admissions between 2000 and 2006 from Denmark.
RESULTS: Of 17,642 patients seeking treatment for DUD, 828 individuals (4.53%) had a history of CVD at treatment entry. Among the remaining patients, 16,820 were traced and 1535 new incident cases of CVD were observed during a mean follow-up time of 7.5 years. The incidence of CVD was associated with intravenous drug use [subhazard ratio (SHR) = 1.41, p < 0.001], not responding to injection question (SHR = 1.23, p = 0.005), older age (SHR = 1.04 per year, p = 0.000), use of prescription methadone (SHR = 1.32, p < 0.001), use of benzodiazepines (SHR = 1.21, p = 0.005), and being referred to methadone treatment (SHR = 1.15, p = 0.022). The use of amphetamines was negatively associated with the risk of CVD within this cohort (SHR = 0.75, p = 0.001).
CONCLUSIONS: Patients injecting drugs using prescribed methadone were at elevated risk for cardiovascular disease and should be monitored for CVD. Opioid medications should be evaluated in terms of their cardiovascular sequelae.