Cocaine and/or marijuana use is present in 1 of 10 patients with a myocardial infarction (MI) aged ≤50 years and is associated with worse all-cause and cardiovascular (CV) mortality, a recent study found. The retrospective study analyzed records of patients presenting with a Type 1 MI at ≤50 years at 2 academic hospitals from 2000 to 2016. Researchers determined:

• Among 2,097 patients with Type 1 MI (mean age 44±5.1 years, 19.3% female, 73% white) with median follow-up of 11.2 years, 224 (10.6%) used cocaine and/or marijuana.
• Substance abuse was associated with significantly higher CV and all-cause mortality despite lower prevalence of traditional risk factors.
• Those with substance use had significantly lower rates of diabetes and hyperlipidemia but were significantly more likely to use tobacco.
• Young adults with MI should be screened for substance abuse to stratify risk.