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. 2022 Aug 16;11(16):e023663.
doi: 10.1161/JAHA.121.023663. Epub 2022 Aug 1.

Clinical Correlates and Outcomes of Methamphetamine-Associated Cardiovascular Diseases in Hospitalized Patients in California

Lara Curran  1 , Gregory Nah  1 , Gregory M Marcus  1 , Zian Tseng  1 , Michael H Crawford  1 , Nisha I Parikh  1
Affiliations

Clinical Correlates and Outcomes of Methamphetamine-Associated Cardiovascular Diseases in Hospitalized Patients in California

Lara Curran et al. J Am Heart Assoc. .

Abstract

Background Methamphetamine misuse affects 27 million people worldwide and is associated with cardiovascular disease (CVD); however, risk factors for CVD among users have not been well studied. Methods and Results We studied hospitalized patients in California, captured by the Healthcare Cost and Utilization Project database, between 2005 and 2011. We studied the association between methamphetamine use and CVD (pulmonary hypertension, heart failure, stroke, and myocardial infarction). Among 20 249 026 persons in the Healthcare Cost and Utilization Project, 66 199 used methamphetamines (median follow-up 4.58 years). Those who used were more likely younger (33 years versus 45 years), male (63.3% versus 44.4%), smoked, misused alcohol, and had depression and anxiety compared with nonusers. Methamphetamine use was associated with the development of heart failure (hazard ratio [HR], 1.53 [95% CI, 1.45-1.62]) and pulmonary hypertension (HR, 1.42 [95% CI, 1.26-1.60]). Among users, male sex (HR, 1.73 [95% CI, 1.37-2.18]) was associated with myocardial infarction. Chronic kidney disease (HR, 2.38 [95% CI, 1.74-3.25]) and hypertension (HR, 2.26 [95% CI, 2.03-2.51]) were strong risk factors for CVD among users. When compared with nonuse, methamphetamine use was associated with a 32% significant increase in CVD, alcohol abuse with a 28% increase, and cocaine use with a 47% increase in CVD. Conclusions Methamphetamine use has a similar magnitude of risk of CVD compared with alcohol and cocaine. Prevention and treatment could be focused on those with chronic kidney disease, hypertension, and mental health disorders.

Trial registration: ClinicalTrials.gov NCT03514693.

Keywords: MINOCA; congestive heart failure; methamphetamine; myocardial infarction; myocardial infarction without coronary artery obstruction; pulmonary hypertension; stroke.

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Figures

Figure 1
Figure 1. Inclusion flow chart.
CVD indicates cardiovascular disease.
Figure 2
Figure 2. Forest plots (hazard ratios or HR [95% CI]) clinical and sociodemographic predictors of cardiovascular disease (CVD) and CVD subtypes among users of methamphetamines.
A, CVD; B, myocardial infarction (MI) or MI without obstructive coronary disease; C, pulmonary hypertension; D, heart failure.
Figure 3
Figure 3. Kaplan–Meier plot for time to development of cardiovascular disease.
A, comparing patients who exclusively use methamphetamine (Met), alcohol (Etoh), or cocaine and nonusers; B, Comparing patients who use methamphetamine (Met) alone or in combination with alcohol (etoh), with cocaine, with both etoh and cocaine, and nonusers.
See this image and copyright information in PMC

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