Increased Risks of Major Cardiac Adverse Events in Stimulant Use Disorder as Compared With Other Substance Use Disorders: A Propensity-score Matching Cohort Study.

IF 4.2 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2025-02-17 DOI:10.1097/ADM.0000000000001461

Nicolas Garel, Kyle T Greenway, Paola Lavin, C William Pike, Rebecca Hyde, Didier Jutras-Aswad, Steven D Tate, Anna Lembke

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引用次数: 0

Abstract

Objectives: Individuals with stimulant use disorders (StSUDs) present an elevated risk of cardiovascular complications compared with the general population. However, it remains unclear whether, within the subpopulation of individuals with substance use disorders (SUDs), those specifically affected by StSUDs face even higher cardiovascular complications.

Methods: We conducted a retrospective cohort study using the EVERSANA databank, spanning from January 2015 to December 2023. The EVERSANA data set comprises deidentified electronic health record data aggregated and standardized across the United States. Participants included patients diagnosed with SUDs, encompassing alcohol, cannabis, opioids, stimulants, tobacco, hallucinogens, sedative-hypnotics, or inhalants. We employed the International Classification of Disease 10th (ICD-10) version codes to define the presence of StSUD and SUD. Major adverse cardiac events (MACE) were assessed, and Cox proportional hazard ratios were adjusted using high-dimensional propensity score (hdPS) matching to account for potential confounders.

Results: Among 137,106 patients with SUD, 7706 (5.6%) had StSUD. The cohort was 50.2% female, 53.0% non-White, with a mean age of 49.1 years (SD±15). After adjustment, stimulant users exhibited significantly higher MACE rates (HR=1.37, 95% CI: 1.22-1.53, P <0.001), including an elevated risk of death (HR=1.23, 95% CI: 1.02-1.47, P =0.026).

Conclusion: Individuals with StSUD face increased MACE compared with those with nonstimulant SUDs.

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与其他物质使用障碍相比，兴奋剂使用障碍中主要心脏不良事件的风险增加：一项倾向评分匹配队列研究。

目的：与普通人群相比，兴奋剂使用障碍（stsud）患者出现心血管并发症的风险升高。然而，目前尚不清楚的是，在物质使用障碍（SUDs）个体亚群中，那些特别受StSUDs影响的人是否面临更高的心血管并发症。方法：我们使用EVERSANA数据库进行了一项回顾性队列研究，时间跨度为2015年1月至2023年12月。EVERSANA数据集包括在美国汇总和标准化的未识别电子健康记录数据。参与者包括被诊断患有sud的患者，包括酒精、大麻、阿片类药物、兴奋剂、烟草、致幻剂、镇静催眠药或吸入剂。我们采用国际疾病分类第10版（ICD-10）代码来定义StSUD和SUD的存在。评估主要不良心脏事件（MACE），并使用高维倾向评分（hdPS）匹配调整Cox比例风险比，以考虑潜在的混杂因素。结果：137106例SUD患者中，7706例（5.6%）为StSUD。队列中女性50.2%，非白人53.0%，平均年龄49.1岁（SD±15）。调整后，兴奋剂使用者的MACE率显著高于非兴奋剂者（HR=1.37, 95% CI: 1.22-1.53）。结论：StSUD患者的MACE高于非兴奋剂sud患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Addiction Medicine 医学-药物滥用

CiteScore

6.10

自引率

9.10%

发文量

260

审稿时长

>12 weeks

期刊介绍： The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.