Methamphetamine use by veterans with HF increased over past decade

Marin Nishimura

ANAHEIM, Calif. — The rate of patients with HF who are veterans and use methamphetamine has increased over a 10-year period, according to data presented at American Heart Association Scientific Sessions.

“Heart failure patients with methamphetamine abuse were younger, more likely to be homeless, unemployed and diagnosed with other substance abuse and psychiatric conditions,” Marin Nishimura, MD, internal medicine resident at University of California, San Diego, said in an interview with Cardiology Today. “We believe these differences, especially their substance abuse issues and psychiatric conditions, are important to take note because we can work to address these specific issues in the MethHF patients to better take care of them.”

Researchers analyzed data from 9,588 patients with HF who were treated at San Diego VA Medical Center from 2005 to 2015. Methamphetamine abuse was identified in 480 patients.

Clinical outcomes of interest included all-cause readmission, time to ED visit and all-cause mortality.

Methamphetamine use in patients with HF increased from 1.7% in 2005 to 8% in 2015. The average age for patients who used was 61 years and 72 years for those who did not use. Psychiatric issues including PTSD and depression were more common in patients who used methamphetamine compared with those who did not use it.

Patients who used methamphetamine had lower instances of CAD compared with those who did not use. Both groups had similar ejection fraction.

Those who used methamphetamine had an increased risk for ED visits (1.9 per year) vs. patients who did not use methamphetamine (0.95 per year; P = .01). All-cause hospital readmissions were also numerically higher in those who used methamphetamine (1.1 per year) compared with patients who did not use methamphetamine (0.7 per year; P = .19).

“We also saw that there are possibly two phenotypes of MethHF, namely methamphetamine-associated heart failure with preserved ejection fraction (MethpEF) and methamphetamine-associated heart failure with reduced ejection fraction (MethrEF),” Nishimura said. “There were similarities between these two disease phenotypes, but we saw that MethrEF patients had higher mortality compared to MethpEF. Because our preliminary study only identified 35 MethrEF and 71 MethpEF patients, we are looking into expanding our study size to further look into these two possible disease entities.” – by Darlene Dobkowski

Reference:

Nishimura M, et al. Presentation T3162. Presented at: American Heart Association Scientific Sessions; Nov. 11-15, 2017; Anaheim, California.

Disclosure: Nishimura reports no relevant financial disclosures.