Heart failure & cardiomyopathies
In-Hospital and 1 Year Incremental Prognostic Value of Drug Abuse Detection in Acute Heart Failure
Authors' conclusion
Drug abuse use was independently associated with a higher occurrence of both in-hospital and 1 year MACEs with an incremental prognostic value. These results suggest a potential interest of a systematic illicit drug screening in these patients.
Study context
- Population
- Patients hospitalized for acute heart failure (AHF) with a drug abuse screening using a urinary assaypatients with AHF included
- Participants
- 458 patients
- Exposure
- Drug abuse detection vs No drug abuse detection
- Outcome
- In-hospital MACEs (all-cause death, resuscitated cardiac arrest or cardiogenic shock) and 1 year MACEs (cardiovascular death or hospitalization for AHF), overall cohort
Methodological details39 French centres, consecutive cohort
- 39 French centres
- Consecutive cohort
Main finding
As reported in the abstract
In-hospital major adverse cardiovascular events (MACEs)
65
14.2%
1 year MACEs
129
28.2%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| In-hospital MACEsDrug abuse detection vs No drug abuse detection · model 1-known comorbidities | OR 4.46 (95% CI 1.88–10.3) | P < 0.001 | |
| In-hospital MACEsDrug abuse detection vs No drug abuse detection · model 2-clinical severity | OR 3.64 (95% CI 1.56–8.26) | P = 0.002 | |
| In-hospital MACEsDrug abuse detection vs No drug abuse detection · propensity-matched population analysis | OR 3.34 (95% CI 1.32–8.70) | P = 0.011 | |
| 1 year survivalWorse survival with drug abuse detection | HR 1.82 (95% CI 1.13–2.92) | P = 0.012 | |
| 1 year MACEsDrug abuse detection vs No drug abuse detection · adjusted for traditional prognosticators | OR 2.54 (95% CI 1.28–4.98) | P = 0.008 | |
| 1 year MACEsDrug abuse detection vs No drug abuse detection · propensity-matched population analysis | OR 2.77 (95% CI 1.98–5.21) | P = 0.001 | |
| 0.050.21520Ratio (log scale) |
- In-hospital MACEs — C-statistic improvement
- 0.04
- In-hospital MACEs — likelihood-ratio (LR) test (both models)
- P < 0.001
- 1 year MACEs — C-statistic improvement
- 0.02
- 1 year MACEs — LR test
- P < 0.001
1 year MACEs
- Positive net reclassification improvement (NRI) and integrated discrimination improvement (IDI)
Original publication
In-Hospital and 1 Year Incremental Prognostic Value of Drug Abuse Detection in Acute Heart Failure. ESC Heart Fail. Published 21 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it