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Cardiomyopathy Hospital Admissions Among Methamphetamine Users
Quick Takes
- Pulmonary hypertension, heart failure, MI, and cardiomyopathy (CM) are associated with methamphetamine use.
- Between 2008 and 2020, the prevalence of CM-associated hospital admissions among methamphetamine users had increased by 231% and the all-cause mortality increased by 195%; with a three-fold increase in younger methamphetamine users (26-40 years old) compared to nonusers.
- The prevalence ratio of CM-associated hospital admissions among methamphetamine users is highest in men aged 41-64 years, non-Hispanic Whites, non-Hispanic Native Americans, and Hispanics compared to non-Hispanic Blacks and has increased by 530% in the western US region and 200% in the southern US region.
Study Questions:
What is the prevalence and what are the demographics of patients in the US population that are methamphetamine users and are admitted for cardiomyopathy (CM)?
Methods:
A retrospective review of the National Inpatient Sample database representing all 50 states from 2008 to 2020 was conducted to identify 12,845,919 CM-associated hospital admissions; 222,727 were diagnosed as methamphetamine users without other substance abuse. Overall national prevalence and temporal trends were reported to determine demographics changes. The prevalence ratio of CM-associated hospital admissions among methamphetamine users was calculated as the number of CM-associated hospital admissions among methamphetamine user cases divided by the number of CM-associated hospital admissions among non-methamphetamine users.
Results:
From 2008 to 2020, the CM hospital admissions significantly increased in men (18%) compared to women (2%) (p < 0.001), non-Hispanic Black (47%), non-Hispanic White (30%), Hispanic (51%), and non-Hispanic Asian (48%) patients, and in patients 41-64 years age (18.84%). Between 2008 and 2020, the all-cause mortality from methamphetamine-associated hospital admissions increased by 674% with a significant increase in men (1021%) and women (534%) (p for trend < 0.001); among White (878%), Black (1170%), and Hispanic (1291%) patients (p < 0.001); and among those aged 18-25 years (485%), 26-40 years (910%), and 41-64 years (918%) (p for trend < 0.001).
Linking methamphetamine users among patients who were admitted to hospital for CM, the numbers increased by 231% (p for trend < 0.001), and all-cause mortality increased by 195% (p for trend < 0.001) from 2008-2020. These hospital admissions were significantly higher in men compared to women (58.52% vs. 41.48%, p < 0 .0001) with ~4-fold increase in men and ~2.5-fold in women (p < 0.001); and increased among all age groups: 18-25 years (2.44% vs. 0.84%, p < 0.0001), 26-40 years (15.61% vs. 5.13%, p < 0.0001), and 41-64 years (55.97% vs. 36.37%, p < 0.0001). CM-associated hospital admissions among methamphetamine users increased 345% for men (p for trend < 0.001) and 122% for women (p for trend < 0.001), 271% non-Hispanic White (p for trend < 0.001), 254% for non-Hispanic Black (p for trend < 0.001), 565% for Hispanic (p for trend < 0.001), and 645% for non-Hispanic Asian (p for trend < 0.001) populations. The US regions showing the most significant increase were the West (530%) (p for trend < 0.001) and South (200%) regions (p for trend < 0.001).
Conclusions:
Based on hospital admission data between 2008 and 2020, CM-associated hospital admissions among methamphetamine users have significantly increased 231%, with the predominance among non-Hispanic White men 41-64 years of age residing in the western and southern regions of the United States.
Perspective:
Methamphetamine (trade name: Desoxyn, common street names: Black Beauties, Crank, Crystal, Ice, Meth, Speed, Trash, Uppers) is a Schedule II stimulant under the Controlled Substances Act that has very limited Food and Drug Administration approved use in the treatment of obesity, narcolepsy, and ADHD. Previous studies have shown the potential risk of heart failure, acute myocardial infarction (MI), and pulmonary hypertension related to the hemodynamics changes that increase heart rate and blood pressure. This study identified the prevalence and trends of patient populations associated with higher methamphetamine use and how this association has impacted the overall increase in hospital admissions for CM. These data can help clinicians perform ongoing surveillance and targeted education, particularly among younger males not typically considered at risk for early cardiovascular disease presentation.
Clinical Topics: Heart Failure and Cardiomyopathies, Cardiovascular Care Team
Keywords: Cardiomyopathies, Methamphetamine
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