Coronary disease & ACSCohort study
Prognostic Impact of Recreational Drug Use on 1-Year Outcomes in NSTEMI and STEMI Patients
- Addiction in Intensive Cardiac Care Units study
- 39 French centers
- prospective urinary testing
- independent adjudication
- propensity matching
Authors' conclusion
Recreational drug use was associated with increased 1-year MACE risk in ACS patients, particularly STEMI, supporting routine drug screening.
Study context
- Population
- Acute coronary syndrome (ACS) patients admitted to intensive cardiac care unitsACS patients, 13.5% had recreational drug detection
- Participants
- 712 patients
- Exposure
- drug-positive vs drug-negative patients
- Outcome
- MACE, defined as cardiovascular death, nonfatal myocardial infarction, or stroke
- Follow-up
- 1 year
Main finding
As reported in the abstract
Hazard ratio
2.70
95% CI 1.30–5.57
P = 0.013
By group
drug-positive vs drug-negative
HR 2.70 (95% CI 1.30–5.57); P = 0.013
- Major adverse cardiovascular events (MACE) overall
- 7.0%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MACE in STEMI (subgroup) · 1 year — drug-positive vs drug-negative | 4.11 (1.60–10.5) | P = 0.005 | |
| MACE in STEMI (subgroup) · 1 year — drug-positive vs drug-negative · propensity matching | 3.39 (1.19–9.62) | P = 0.022 | |
| 0.050.21520Hazard ratio (log scale) |
MACE in non-ST-elevation myocardial infarction (subgroup) · 1 year
- Association not significant
Original publication
Prognostic Impact of Recreational Drug Use on 1-Year Outcomes in NSTEMI and STEMI Patients. JACC Adv. Published 23 January 2026. doi:10.1016/j.jacadv.2025.102574
Summarised from the published abstract; every number is checked against it