COMORBIDITIES AND PROCEDURAL OUTCOMES IN STEMI PATIENTS WITH AND WITHOUT A HISTORY OF DRUG ABUSE

Abstract

Therapeutic Area

ASCVD/CVD Risk Factors

Background

Patients with a history of drug abuse are at increased risk for cardiovascular events, including ST-segment elevation myocardial infarction (STEMI). However, the prevalence of comorbidities and procedural outcomes in this population remain understudied. This study aimed to compare the prevalence of comorbidities and procedural outcomes in STEMI patients with and without a history of drug abuse.

Methods

A total of 180,265 patients diagnosed with STEMI in 2020 with NIS data using SPSS were included in this registry study. Patients were categorized into two groups: those with a history of drug abuse (n=8,843; 4.9%) and those without (n=171,422; 95.1%). The prevalence of comorbidities, including congestive heart failure, diabetes, and renal failure, was compared between the two groups using odds ratios (OR) and 95% confidence intervals (CI). Procedural outcomes, such as percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG), were also analyzed.

Results

Drug users had a higher prevalence of congestive heart failure (69% vs. 62%) and renal failure (31% vs. 39%) compared to non-drug users. However, diabetes was less prevalent among drug users (14% vs. 43%). Non-drug users with congestive heart failure had higher odds of mortality (OR 1.353, 95% CI: 1.301-1.408) compared to those without, while drug users had lower odds (OR 0.724, 95% CI: 0.581-0.902). No significant differences in mortality odds were observed for diabetes in either group. Non-drug users with renal failure had higher odds of mortality (OR 1.266, 95% CI: 1.218-1.314), while drug users exhibited no significant change. Among patients undergoing procedures, non-drug users had higher rates of single-vessel PCI (0.436% vs. 0.339%), double-vessel PCI (0.080% vs. 0.034%), and single-vessel CABG (0.046% vs. 0.034%) compared to drug users.

Conclusions

This study highlights the differences in comorbidities and procedural outcomes between STEMI patients with and without a history of drug abuse. Drug users had a higher prevalence of congestive heart failure and renal failure but a lower prevalence of diabetes compared to non-drug users. Non-drug users with congestive heart failure and renal failure had higher odds of mortality, while drug users had lower or no significant change in mortality odds. Non-drug users also had higher rates of PCI and CABG procedures compared to drug users. These findings emphasize the need for tailored management strategies considering the unique comorbidity profiles and procedural outcomes in STEMI patients with a history of drug abuse.