Cardiovascular diseases as underlying cause of death among treated drug users Pooled analyze of cohort study data from Barcelona,Romunia, Malta,Latvia, Croatia, Slovenia and Norway Cardiovascular diseases are also complications related to drug abuse - heroin direct toxcic effect on myocardial muscle, coronary arteries increase parasympatic tone via effect on CV centre in med. obl. hemorrhagic or ischemic stroke - cocaine, amphetamine, methamphetamine cardiotoxity Number and sheare of cohort members, deaths, and deaths due to CV causes of death Men Women Total N cohort members N death 24 231 6 947 31 178 2 406 529 2 935 Gender Men State Average age at entry Aaverage age at death or end of study Difference Deceased 32,1 36,6 Alive 28,7 35,7 4,5 7 N death due to CV diseases 160 32 193 % of all deaths % of CV deaths 9, 93 % 7, 61 % 9, 41 % 6, 65 % 6, 05 % 6, 58 % Difference deceased M-W Women -1 -1,3 Deceased 33,1 37,9 Alive 28,6 35,1 -0,3 4,8 6,5 Mean age at death due to diseases as underlyung cause of death Underlying cause of death Number of cases Mean age at death HIV Liver infections Infectious diseases Tuberculosis Neoplasms Nervous. Cardiovascular Respiratory Digestive sys. Other causes Summ 295 47 26 37,0 42,0 38,0 8 102 14 192 115 80 149 1028 38,1 44,6 39,6 36,8 38,5 42,1 34,8 Mean age at death in Slovenia in 2013, population >65 years 46,1 55,8 45,5 56,1 55,1 54,7 Minimum age at death of treated drug users 22,8 22,1 21,4 19,6 23,7 27,2 16,5 16,7 28,8 18,8 Mean age at death due to external causes as underlyung cause of death Underlying cause of death Overdose Suicides Traffic accidents Injuries Accidents Agressions Summ Number of cases Mean age at death 727 32,7 100 31,3 60 34,0 51 34,0 48 32,2 33 29,6 1019 SD mean age at death 8,0 7,9 8,3 8,8 9,8 9,1 Minimum age at death 15,9 16,9 17,5 17,3 17,4 18,5 Age standardized death rate (DSR) among treated drug users, pooled cohort data All causes of death, treated drug users 15-49 years Sex SMR 95% CI low 95 CI high Men Women Total 12,2 24,7 13,4 11,6 22,2 11,8 12,8 27,4 14,0 CV diseases as causes of death, treated drug users 15-49 years Sex SMR 95% CI low 95 CI high Men Women Total 9,9 18,3 10,7 8,4 12,8 9,2 11,6 26,1 12,4 DSR/1000 PY 17,1 13,9 15,8 DSR/1000 PY 1,7 1,5 1,6 Years of potential life lost (YPLL), among treated drug users, pooled cohort data YPLL due to all Sex causes of death, treated drug users Men 10-64 years Women Total YPLL due to CV causes of death, treated deug users 1064 Number of deceased 1689 368 2057 YPLL YPLL/ 1 deceased 33,6 33,5 33,8 56 785 12 315 69 537 Sex Number of deceased YPLL YPLL/ 1 deceased Men Women Total 158 32 190 5285 1025 6310 33,4 32,0 33,2 YPLL/1 deceased in EU-28, age 15-49 30,4 22,9 22,4 Cardiovascular causes of death Cause of death Number % Hypertension Acute ischemic heart disease IHD acc. Chronic ischemic heart disease CIHD Pulmonary embolism, acute cor pulmonale Endocarditis and valvular diseases Cardiomiopathias Cardiac arrest Heart failure Hemorrhagic stroke Undetermined stroke Atherosclerosis aortae Pheripheral thrombosis Total 2 29 17 12 13 73 4 17 19 2 2 1 191 1 15,2 8,9 6,3 6,8 38,2 2,1 8,9 9,9 1,0 1,0 0,5 100,0 Conclusion Drug users dies younger and has higher cardiovascular mortality rate than its peer population. It is needed to search, monitor, and cure early symptoms of cardiovascular disease also in drug users population.
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