ArticleHeart (British Cardiac Society)2021
Recreational substance use among patients with premature atherosclerotic cardiovascular disease.
Article in Heart (British Cardiac Society), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Angiographic and early in-hospital profile of primary percutaneous coronary intervention in patients with substance use disorder presenting with ST-segment elevation myocardial infarction.Scientific reports · 2026Observational
- Acute Coronary Syndrome and Recreational Drug Use: A Comprehensive Review.Medicina (Kaunas, Lithuania) · 2026Review
- Age-Dependent Geographic Convergence of Overdose and Cardiovascular Emergency Medical Services Calls: A Spatial Point Process Analysis.Preventing chronic disease · 2026Article
- Acute coronary syndromes across the lifespan of women.NPJ cardiovascular health · 2026Review
- Substance use in adolescence is associated with future cardiovascular disease risk: findings from the national longitudinal study of adolescent to adult health.Frontiers in nutrition · 2026Article
- Lifetime Cannabis Use and Incident Hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.Hypertension (Dallas, Tex. : 1979) · 2025Observational
- Risk factor monitoring, management and use of prevention medicines in those with a history of premature coronary heart disease.Open heart · 2025Article
- Joint Exposure to Ozone and Temperature and Acute Myocardial Infarction Among Adults Aged 18 to 64 Years in the United States.Circulation · 2025Article
- Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms.Biomolecules · 2025Review
- Myocardial Infarction Triggered by Marijuana Use.JACC. Case reports · 2025Article
- Valvular dysfunction and cardiovascular risk in individuals with opioid use disorder who are maintained on buprenorphine/naloxone: a focus on pan-immune-inflammation value and uric acid-to-albumin ratio.Frontiers in cardiovascular medicine · 2025Article
- Smoking or Vaping Cannabis and Cardiovascular Function: Is Δ-9-Tetrahydrocannabinol the Main Culprit?Journal of the American Heart Association · 2024Article
- Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA).Vascular medicine (London, England) · 2024Article
- Pre-pregnancy substance use and first trimester cardiovascular health among nulliparous pregnant people: The nuMoM2b Study.Paediatric and perinatal epidemiology · 2024Article
- Call to action for acute myocardial infarction in women: international multi-disciplinary practical roadmap.European heart journal open · 2024Review
- Addressing Psychosocial Care Needs in Women with Peripheral Artery Disease.Current cardiology reports · 2024Review
- Distinctive characteristics, risk factors, and prevention of premature myocardial infarction: A narrative review.Journal of family medicine and primary care · 2024Review
- Identifying risk factors and mortality rate of premature coronary artery disease in young Saudi population.Scientific reports · 2024Article
- What Causes Premature Coronary Artery Disease?Current atherosclerosis reports · 2024Review
Corrections and comments
- Commented on by
- Erratum issuedCorrection:2021
Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDespite an upsurge in the incidence of atherosclerotic cardiovascular diseases (ASCVD) among young adults, the attributable risk of recreational substance use among young patients has been incompletely evaluated. We evaluated the association of all recreational substances with premature and extremely premature ASCVD.
methodsIn a cross-sectional analysis using the 2014-2015 nationwide Veterans Affairs Healthcare database and the Veterans wIth premaTure AtheroscLerosis (VITAL) registry, patients were categorised as having premature, extremely premature or non-premature ASCVD. Premature ASCVD was defined as having first ASCVD event at age <55 years for men and <65 years for women. Extremely premature was defined as having first ASCVD event at age <40 years while non-premature ASCVD was defined as having first ASCVD event at age ≥55 years for men and ≥65 years for women. Patients with premature ASCVD (n=135 703) and those with extremely premature ASCVD (n=7716) were compared against patients with non-premature ASCVD (n=1 112 455). Multivariable logistic regression models were used to study the independent association of all recreational substances with premature and extremely premature ASCVD.
resultsCompared with patients with non-premature ASCVD, patients with premature ASCVD had a higher use of tobacco (62.9% vs 40.6%), alcohol (31.8% vs 14.8%), cocaine (12.9% vs 2.5%), amphetamine (2.9% vs 0.5%) and cannabis (12.5% vs 2.7%) (p<0.01 for all comparisons). In adjusted models, the use of tobacco (OR 1.97, 95% CI 1.94 to 2.00), alcohol (OR 1.50, 95% CI 1.47 to 1.52), cocaine (OR 2.44, 95% CI 2.38 to 2.50), amphetamine (OR 2.74, 95% CI 2.62 to 2.87), cannabis (OR 2.65, 95% CI 2.59 to 2.71) and other drugs (OR 2.53, 95% CI 2.47 to 2.59) was independently associated with premature ASCVD. Patients with polysubstance use had a graded response with the highest risk (~9-fold) of premature ASCVD among patients with use of ≥4 recreational substances. Similar trends were observed among patients with extremely premature ASCVD. Gender interactions with substance use were significant (p-interaction <0.05), with recreational substance use and premature ASCVD showing stronger associations among women than in men with premature ASCVD.
conclusionsAll subgroups of recreational substances were independently associated with a higher likelihood of premature and extremely premature ASCVD. Recreational substance use confers a greater magnitude of risk for premature ASCVD among women. A graded response relationship exists between increasing number of recreational substances used and higher likelihood of early-onset ASCVD.
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