Abstract P456: The Cardiovascular Profile of Patients by Methamphetamine, Cocaine, Opiate, and Cannabis Use

Abstract

Introduction: The role of recreational substances such as alcohol, tobacco and illicit drugs in the development of clinical cardiovascular disease is established. Recent studies have started to compare cardiovascular endpoints across individual types of substances, but these studies have been limited in generalizability or do not distinguish by drug type. We conducted a cross-sectional analysis to investigate the cardiovascular profile of patients by type of substance in a large health care system. Methods: We included 346,008 adult patients who received regular care (at least 1 visit per year in 2 consecutive years) in a California health system during 2016-2020. The baseline visit was defined as the earliest visit in the 2 nd year, allowing at least 1 year for data capture. Substance use and covariates were ascertained using ICD codes from medical records at or prior to baseline. We used logistic regression to assess the association of cardiovascular characteristics by each substance use. Results: Of the 346,008 patients included, the mean age was 53 years, and 58% were female. There were 8752 (2.5%) patients with a history of substance use. The 4 most common substances were 1479 (0.43%) patients with codes for methamphetamine use, 1002 (0.29%) for cocaine, 2310 (0.66%) for opiate, and 3145 (0.91%) for cannabis. Compared to those with no history of substance use, patients with substance use were more likely to be male, and despite being younger or of similar age, had worse cardiovascular risk factors (Table). All substances had a higher adjusted odds of tobacco use and alcohol dependence. Patients with cocaine use had a higher odds of male, CKD, stroke, MI and HF (all odds ratios >2), whereas the profile differed in opiate use, with the highest odds being hypertension and COPD. Conclusion: Methamphetamine, cocaine, opiate, and cannabis use each had unique cardiovascular patient profiles. These results offer insight for risk stratification and may represent treatment strategies to prevent adverse events.