Methamphetamine use and heart failure: Prevalence, risk factors, and predictors

John R Richards, Brian N. Harms, Amanda Kelly, Samuel D Turnipseed

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To compare methamphetamine users who develop heart failure to those who do not and determine predictors. Methods: Patients presenting over a two-year period testing positive for methamphetamine on their toxicology screen were included. Demographics, vital signs, echocardiography and labs were compared between patients with normal versus abnormal B-type natriuretic peptide (BNP). Results: 4407 were positive for methamphetamine, 714 were screened for heart failure, and 450 (63%) had abnormal BNP. The prevalence of abnormal BNP in methamphetamine-positive patients was 10.2% versus 6.7% for those who were negative or not tested. For methamphetamine-positive patients, there was a tendency for higher age and male gender with abnormal BNP. A higher proportion of Whites and former smokers had abnormal BNP and higher heart and respiratory rates. Echocardiography revealed disparate proportions for normal left ventricular ejection fraction (LVEF) and severe dysfunction (LVEF <. 30%), LV diastolic function, biventricular dimensions, and pulmonary arterial pressures between subgroups. For methamphetamine-positive patients with abnormal BNP, creatinine was significantly higher, but not Troponin I. Logistic regression analysis revealed predictors of abnormal BNP and LVEF <. 30% in methamphetamine-positive patients, which included age, race, smoking history, elevated creatinine, and respiratory rate. Conclusion: Methamphetamine-positive patients have a significantly higher prevalence of heart failure than the general emergency department population who are methamphetamine-negative or not tested. The methamphetamine-positive subgroup who develop heart failure tend to be male, older, White, former smokers, and have higher creatinine, heart and respiratory rates. This subgroup also has greater biventricular dysfunction, dimensions, and higher pulmonary arterial pressures.

Original languageEnglish (US)
JournalAmerican Journal of Emergency Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Methamphetamine
Brain Natriuretic Peptide
Heart Failure
Respiratory Rate
Stroke Volume
Creatinine
Echocardiography
Arterial Pressure
Heart Rate
Lung
Troponin I
Vital Signs
Toxicology
Hospital Emergency Service
Logistic Models
Smoking
History
Regression Analysis
Demography

Keywords

  • Amphetamine
  • Cardiomyopathy
  • CHF
  • Echocardiography
  • Heart failure
  • Methamphetamine
  • Toxicology

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Methamphetamine use and heart failure : Prevalence, risk factors, and predictors. / Richards, John R; Harms, Brian N.; Kelly, Amanda; Turnipseed, Samuel D.

In: American Journal of Emergency Medicine, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Objectives: To compare methamphetamine users who develop heart failure to those who do not and determine predictors. Methods: Patients presenting over a two-year period testing positive for methamphetamine on their toxicology screen were included. Demographics, vital signs, echocardiography and labs were compared between patients with normal versus abnormal B-type natriuretic peptide (BNP). Results: 4407 were positive for methamphetamine, 714 were screened for heart failure, and 450 (63{\%}) had abnormal BNP. The prevalence of abnormal BNP in methamphetamine-positive patients was 10.2{\%} versus 6.7{\%} for those who were negative or not tested. For methamphetamine-positive patients, there was a tendency for higher age and male gender with abnormal BNP. A higher proportion of Whites and former smokers had abnormal BNP and higher heart and respiratory rates. Echocardiography revealed disparate proportions for normal left ventricular ejection fraction (LVEF) and severe dysfunction (LVEF <. 30{\%}), LV diastolic function, biventricular dimensions, and pulmonary arterial pressures between subgroups. For methamphetamine-positive patients with abnormal BNP, creatinine was significantly higher, but not Troponin I. Logistic regression analysis revealed predictors of abnormal BNP and LVEF <. 30{\%} in methamphetamine-positive patients, which included age, race, smoking history, elevated creatinine, and respiratory rate. Conclusion: Methamphetamine-positive patients have a significantly higher prevalence of heart failure than the general emergency department population who are methamphetamine-negative or not tested. The methamphetamine-positive subgroup who develop heart failure tend to be male, older, White, former smokers, and have higher creatinine, heart and respiratory rates. This subgroup also has greater biventricular dysfunction, dimensions, and higher pulmonary arterial pressures.",
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