Methamphetamine-associated HF hospitalizations rise in US
Between 2002 and 2014, methamphetamine-associated HF hospitalizations increased in the U.S., especially in regions in the West Coast, according to a new study published in the Journal of the American Heart Association.
“Methamphetamine is one of the most potent stimulants someone can put in their body. While it can be injected, snorted or swallowed, one of the most common ways to abuse meth is by smoking it and delivering an enormous dose of unfiltered stimulant to the heart,” Stephen D. Dickson, MD, MS, cardiologist at Midwest Heart and Vascular Specialists, Independence, Missouri, told Healio. “Such toxic exposure can trigger an overwhelming catecholamine cascade leading to tachycardia, hypertension, arrhythmia, vasospasm, and dilated cardiomyopathy.”
For the cross-sectional period-prevalence study, Dickson and colleagues evaluated all hospital discharge data of adults with primary HF hospitalizations and a secondary diagnosis of methamphetamine, cocaine or alcohol abuse from the U.S. National Inpatient Sample.
All 2014 methamphetamine-associated HF admissions were categorized through regional census division to assess geographical distributions. Researchers then compared characteristics of methamphetamine-associated HF hospitalizations with all other HF hospitalizations.
From 2002 to 2014, U.S. nationwide methamphetamine-associated HF hospitalizations increased from 547 to 6,625 (mean age, 49 years; 79% men). Researchers observed methamphetamine abuse to be more common among primary HF hospitalizations compared with all-cause hospitalizations (7.4 vs. 6.4 per 1,000; P < .001).
Patients hospitalized with methamphetamine-associated HF tended to be younger (mean age, 48.9 years vs. 72.4 years), likelier to be on Medicaid (59.4% vs. 8.8%) or uninsured (12% vs. 2.6%) and likelier to present to urban hospitals (43.8% vs. 28.3%) compared with patients hospitalized with non-methamphetamine-associated HF (P < .001 for all). In addition, patients hospitalized with methamphetamine-associated HF demonstrated higher rates for psychiatric comorbidities and were likelier to leave the hospital against medical advice.
The prevalence of methamphetamine-associated HF hospitalizations was nearly 500 times higher in the Pacific region compared with the Middle Atlantic region in 2014, according to the researchers.
According to Dickson, before these findings, there were very little data addressing the national prevalence or geographical distribution of methamphetamine-associated HF admissions in the U.S.
“Recognizing and documenting methamphetamine abuse in HF patients is a critical first step in understanding how deep this issue goes,” Dickson told Healio. “I believe our study underestimates the amount of methamphetamine-associated HF because methamphetamine abuse is often not considered or documented in HF patients. Eventually, health policies targeting larger systems of care will be necessary to address this growing problem.”
For more information:
Stephen D. Dickson, MD, MS, can be reached at stephen.dickson@hcahealthcare.com.
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