Illicit Drug Use Seen in One-Third of Sudden Cardiac Deaths in Younger Adults

Cannabis most common illicit drug, but polysubstance use also common

By Lori Solomon HealthDay Reporter

FRIDAY, Aug. 4, 2023 (HealthDay News) — Approximately one-third of patients 50 years or younger with sudden cardiac death (SCD) have positive toxicology for illicit drugs, according to a study published online June 7 in Heart Rhythm.

Adam Trytell, M.B.B.S., from St. Vincent’s Hospital Melbourne in Australia, and colleagues identified rates of illicit drug use in younger patients with SCD using data from 523 patients with confirmed out-of-hospital cardiac arrest (ages 18 to 50 years) with a toxicological assessment (April 2019 to April 2021).

The researchers found that 32.5 percent of patients had either positive toxicology for illicit drugs (138 patients) or negative toxicology but reported regular drug use (32 patients). It was significantly more common for patients with SCD and illicit drug use to be male (81.2 versus 72.3 percent), smokers (38.8 versus 19.8 percent), and excess alcohol drinkers (30.6 versus 20.6 percent). Furthermore, it was significantly more common for those with SCD to have a psychiatric diagnosis (38.8 versus 25.7 percent), lower body mass index (29.4 versus 31.7 kg/m²), and lower rates of hypertension (10.6 versus 18.6 percent). Death occurred commonly while sedentary (47.5 percent) or during sleep (45.8 percent). There were no differences in rates of coronary disease or cardiomyopathy when accounting for these baseline differences. The most common illicit drug used was cannabis (106 patients), but polysubstance abuse occurred frequently (25 patients).

“Our findings raise the question: Is substance abuse underestimated or does it lead to a higher rate of cardiovascular pathology that results in SCD?” lead investigator Elizabeth D. Paratz, M.B.B.S., Ph.D., also of St. Vincent’s Hospital Melbourne, said in a statement. “We know that some young people may have a genetic predisposition for sudden death or developing coronary disease, but drug use may interact with this tendency to accelerate poor outcomes.”