History of illicit drug use in adults with acute myocardial infarction: Temporal trends from the French national hospital discharge database

Abstract

Illicit drugs have become more available and diverse in recent decades. There is growing evidence that cannabis, cocaine and non-acute opioid use is associated with cardiovascular risk, including acute coronary events. In this retrospective study, we aimed to identify and describe the history of illicit drug use in patients with acute myocardial infarction hospitalized between 2011 and 2022 in France. We collected data for all adult patients hospitalized for acute myocardial infarction in 1546 healthcare facilities from 01 January 2011 to 31 December 2022. A history of illicit drug use was identified through patient medical records. The rates of illicit drug use history in patients with acute myocardial infarction were analysed across four 3-year time periods in various age groups. Over 12years, 1,011,706 patients with acute myocardial infarction were identified. Illicit drug use was especially frequent in very young patients with acute myocardial infarction (aged 18-24years) compared with older patients with acute myocardial infarction. In this very young acute myocardial infarction population there was a 161% increase in illicit drug use over 12years (9.7 to 14.9%; P=0.0016). In addition, illicit drug use rates increased across all age groups of patients with acute myocardial infarction over time. Although this observation is based on a retrospective study of an administrative database, it could contribute to a scientific rationale for implementing systematic toxicology screening for patients with acute myocardial infarction in France.