Association of substance use with stroke in heart failure by community socioeconomic distress

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-09-18 DOI:10.1016/j.drugalcdep.2025.112890

Brian Witrick , Frank Annie , Timothy Dotson , Wes Kimble , George Sokos , Christopher Bianco , Sarah Rinehart , Megan Pate , Evonne Richards , Brian Hendricks

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引用次数: 0

Abstract

Introduction

Substance use is common among individuals with heart failure (HF) and is linked to cardiotoxic effects and adverse outcomes. Given the increased vulnerability of HF patients to ischemic stroke, understanding how substance use and community distress contribute to this risk is vital for optimizing clinical prevention strategies. This study examined whether substance use increases stroke risk among HF patients and whether this association differs by community distress level.

Methods

We conducted a multicenter study using data from HF patients treated at WVU Medicine and Charleston Area Medical Center (CAMC) in West Virginia between 2017 and 2023. Multivariable logistic regression assessed the association between substance use and ischemic stroke, stratified by community distress level and adjusted for demographics and comorbidities.

Results

Among 33,663 individuals with HF in the WVU Medicine cohort, 2651 (7.88 %) experienced a stroke. Among 8050 in the CAMC cohort, 900 (11.18 %) experienced a stroke. Overall, among both cohorts, patients with substance use disorder diagnoses had greater odds of stroke. WVU (aOR, 1.36; 95 % CI, 1.14–1.63) and CAMC (aOR, 3.50; 95 % CI, 2.85–4.55). In distressed communities, the association was stronger: WVU (aOR, 1.68; 95 % CI, 1.34–2.09) and CAMC (aOR, 3.70; 95 % CI, 3.03–4.52). In non-distressed communities, only the CAMC cohort showed a significant association (aOR, 1.80; 95 % CI, 1.63–2.09).

Conclusions and relevance

Substance use is linked to higher stroke risk among HF patients, especially in socioeconomically distressed communities. Addressing both clinical and structural factors is essential for effective stroke prevention in this population.

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药物使用与社区社会经济困境心力衰竭卒中的关系

药物使用在心力衰竭（HF）患者中很常见，并与心脏毒性作用和不良结局有关。鉴于心衰患者对缺血性卒中的易感性增加，了解药物使用和社区困扰如何导致这种风险对于优化临床预防策略至关重要。本研究考察了药物使用是否会增加心衰患者的卒中风险，以及这种关联是否因社区痛苦程度而异。方法我们开展了一项多中心研究，使用了2017年至2023年在西弗吉尼亚州WVU医学和查尔斯顿地区医学中心（CAMC）治疗的HF患者的数据。多变量logistic回归评估药物使用与缺血性卒中之间的关系，根据社区痛苦水平分层，并根据人口统计学和合并症进行调整。结果在WVU医学队列的33,663例HF患者中，2651例（7.88%）发生卒中。在CAMC队列的8050人中，900人（11.18%）经历过中风。总的来说，在这两个队列中，被诊断为物质使用障碍的患者中风的几率更大。WVU （aOR, 1.36; 95% CI, 1.14-1.63）和CAMC （aOR, 3.50; 95% CI, 2.85-4.55）。在贫困社区，相关性更强：WVU （aOR, 1.68; 95% CI, 1.34-2.09）和CAMC （aOR, 3.70; 95% CI, 3.03-4.52）。在非贫困社区中，只有CAMC队列显示出显著的相关性（aOR, 1.80; 95% CI, 1.63-2.09）。结论和相关性药物使用与心衰患者卒中风险增加有关，特别是在社会经济困难的社区。解决临床和结构因素对有效预防该人群中风至关重要。

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

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.