Study Finds Stopping Methamphetamine Use Can Improve Cardiac Function

Quitting methamphetamine use can reverse the damage the drug causes to the heart and improve heart function in abusers when combined with appropriate medical treatment, potentially preventing future drug-related cases of heart failure or other worse outcomes, according to a study published May 29 in JACC: Heart Failure.

Stephan Schürer, MD, et al.,looked at 30 patients abusing methamphetamines to assess if heart function improved after discontinuing methamphetamine use. Patients were on average 30 years old and over 93 percent were male. All had a left ventricular ejection fraction of less than 40 percent. Over 83 percent were highly symptomatic and suffered from labored breathing. One-third also developed intracardiac thrombi. All patients received medical treatment including supportive measures and guideline-supported medical therapy, which included automatic implantable cardioverter-defibrillator or wearable cardioverter-defibrillator in some patients.

Results showed that symptoms and cardiac function improved significantly in patients who discontinued methamphetamine use. Also, patients who discontinued the drugs had a lower incidence of the primary endpoint of death, non-fatal stroke and re-hospitalization for heart failure versus those who continued the abuse methamphetamines while on medical therapy, 57 percent vs. 13 percent, respectively.

"Methamphetamine associated cardiac myopathy will become a growing cause of heart failure in young adults," said Norman Mangner, MD, senior author on the study and a physician at the Heart Center Leipzig in Leipzig, Germany. "Due to the chance to recover cardiac function and symptoms at an early stage of the disease, early detection of heart problems in patients with methamphetamine abuse could prevent further deterioration of the cardiomyopathy."

In an accompanying editorial, Tariq Ahmad, MD, MPH, FACC; Jacob N. Schroder, MD; and James L. Januzzi Jr., MD, FACC, explain that the study provides objective data showing that in methamphetamine abusers, cardiac function will only improve after they quit using the drugs, and these findings should impact the treatment plan.

"Rather than simply administering a cocktail of neurohormonal blockade to patients with suspected methamphetamine-associated cardiomyopathy, the majority of focus should be on helping such patients quit using methamphetamines," they conclude.

"[This study] emphasizes the fact that the growing drug epidemic will have long-term cardiovascular consequences in addition to the known short-term tragic events," adds Christopher M. O'Connor, MD, FACC, editor-in-chief of JACC: Heart Failure.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Implantable Devices, SCD/Ventricular Arrhythmias, Acute Heart Failure

Keywords: Adult, Amphetamine-Related Disorders, Cardiomyopathies, Defibrillators, Implantable, Germany, Heart Failure, Hospitalization, Methamphetamine, Muscular Diseases, Stroke, Stroke Volume

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