Methamphetamine-associated heart failure: Clinical characteristics and outcomes in a safety net population

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2024-12-28 DOI:10.1016/j.hrtlng.2024.11.012

Anjali B. Thakkar MD MBA, Matthew S. Durstenfeld MD MAS, Yifei Ma MS, Sithu Win MD, Priscilla Y. Hsue MD

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引用次数: 0

Abstract

Background

Methamphetamine use is increasing and is associated with development of heart failure (HF). However, clinical characteristics and outcomes have not been well-described.

Objective

To compare outcomes among individuals with HF with and without methamphetamine use in a safety-net setting.

Methods

This retrospective matched cohort study included individuals with HF with history of methamphetamine use and age, gender-, and year-matched controls without history of methamphetamine use in a municipal health system from 2001 to 2019. One thousand seven hundred seventy-one individuals with methamphetamine use and HF and 3,542 age, sex, and year-of-HF-diagnosis matched controls with HF without methamphetamine use were included. The primary outcome was all-cause mortality. Secondary outcomes included time to HF hospitalization, 30-day, 90-day, and one-year HF, and all-cause readmissions.

Results

The median age of the cohort was 52.1 years and 22.6 % were female. Black/African American was the most common racial identity (methamphetamine: 49.1 %; no methamphetamine: 33 %). There was no significant difference in mortality between groups (40% vs 36.6 %,HR 1.00,95 % CI 0.91,1.10,p = 1.00). A subset had an index HF hospitalization (n = 1,404, 26.4 %) during the study period, including 637 (35.9 %) with history of methamphetamine use and 767 (21.7 %) without history of methamphetamine use (relative risk 1.66,95 % CI 1.52–1.81,p < 0.0001). Among those who were ever hospitalized for HF, individuals with methamphetamine use had increased risk of HF and all-cause readmission at 30 days (RR 1.92,95 % CI 1.36–2.70,p < 0.001), 90 days (RR 1.69,95 % CI 1.35–2.12,p < 0.001), and one year (RR 1.61,95 % CI 1.36–1.91,p < 0.001).

Conclusion

Despite having higher all-cause and HF readmission risk, individuals with methamphetamine-associated HF did not have higher mortality risk.

查看原文本刊更多论文

甲基苯丙胺相关性心力衰竭：安全网人群的临床特征和结果。

背景：甲基苯丙胺的使用正在增加，并与心力衰竭（HF）的发展有关。然而，临床特征和结果尚未得到很好的描述。目的：比较在安全网环境下使用甲基苯丙胺和不使用甲基苯丙胺的HF患者的预后。方法：这项回顾性匹配队列研究包括2001年至2019年在市政卫生系统中有甲基苯丙胺使用史的HF患者和年龄、性别和年份匹配的无甲基苯丙胺使用史的对照组。纳入了1771例使用甲基苯丙胺和HF的个体，以及3542例年龄、性别和HF诊断年份相匹配的不使用甲基苯丙胺的HF对照。主要结局为全因死亡率。次要结局包括HF住院时间、30天、90天和1年HF，以及全因再入院。结果：队列的中位年龄为52.1岁，女性为22.6%。黑人/非裔美国人是最常见的种族身份(甲基苯丙胺：49.1%；不含甲基苯丙胺：33%)。两组间死亡率无显著差异（40% vs 36.6%,HR 1.00, 95% CI 0.91,1.10,p = 1.00）。一个亚组在研究期间有HF住院指数（n = 1,404, 26.4%），其中637人（35.9%）有甲基苯丙胺使用史，767人（21.7%）没有甲基苯丙胺使用史（相对风险1.66,95% CI 1.52-1.81,p < 0.0001）。在曾经因HF住院的患者中，使用甲基苯丙胺的个体在30天（RR 1.92, 95% CI 1.36-2.70,p < 0.001）、90天（RR 1.69, 95% CI 1.35-2.12,p < 0.001）和1年（RR 1.61, 95% CI 1.36-1.91,p < 0.001）时HF和全因再入院的风险增加。结论：尽管有较高的全因和心衰再入院风险，甲基苯丙胺相关性心衰患者没有较高的死亡风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.