{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:05:05Z","timestamp":1771409105357,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":273,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fondation Coeur et Recherche"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The study aims to assess the in-hospital and 1 year incremental prognostic value of recent drug abuse use, detected by a systematic urinary screening, in a consecutive cohort of patients hospitalized for acute heart failure (AHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients admitted for AHF with a drug abuse screening using a urinary assay were included in this prospective multicentric study (39 French centres). The outcomes were (i) in-hospital major adverse cardiovascular events (MACEs) defined as all-cause death, resuscitated cardiac arrest or cardiogenic shock; and (ii) 1 year MACEs defined as cardiovascular death or hospitalization for AHF. Incremental prognostic value was assessed using the C-index, the global \u03c72 and likelihood-ratio (LR) test, the net reclassification improvement (NRI) and integrated discrimination improvement (IDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 458 patients with AHF were included (mean age 68 \u00b1 14 years, 67% male, 79% of new heart failure onset). In-hospital and 1 year MACEs occurred, respectively, in 65 (14.2%) and 129 (28.2%) patients. Drug abuse detection was independently associated with in-hospital MACEs [model 1\u2014known comorbidities: odds ratio (OR) = 4.46, 95% confidence interval (CI) (1.88\u201310.3), P &amp;lt; 0.001; model 2\u2014clinical severity: OR = 3.64, 95% CI (1.56\u20138.26), P = 0.002], even after propensity-matched population analysis [OR = 3.34, 95% CI (1.32\u20138.70), P = 0.011], with a significant incremental prognostic value over and above traditional risk factors (C-statistic improvement 0.04 with LR test P &amp;lt; 0.001 for both models). Patients with drug abuse detection had worse 1 year survival: HR = 1.82, 95% CI (1.13\u20132.92), P = 0.012. Drug abuse detection was independently associated with 1 year MACEs after adjustment with traditional prognosticators [OR = 2.54, 95% CI (1.28\u20134.98), P = 0.008] and propensity-matched population analysis [OR = 2.77, 95% CI (1.98\u20135.21), P = 0.001], with an incremental prognostic value as well (C-statistic improvement 0.02, LR test P &amp;lt; 0.001, positive NRI and IDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Drug abuse use was independently associated with a higher occurrence of both in-hospital and 1 year MACEs with an incremental prognostic value. These results suggest a potential interest of a systematic illicit drug screening in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT05063097.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15118","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T06:40:32Z","timestamp":1747809632000},"page":"2736-2748","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In-Hospital and 1 Year Incremental Prognostic Value of Drug Abuse Detection in Acute Heart Failure"],"prefix":"10.1093","volume":"12","author":[{"given":"Charles","family":"Fauvel","sequence":"first","affiliation":[{"name":"Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen , Rouen 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