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Introduction: Methamphetamine is one of the most commonly abused illegal substances in the United States. Heart failure due to Methamphetamine use (MethHF) is a poorly characterized disease entity that appears to be on the rise.
Hypothesis: We hypothesized that in a VA population over a 15year period, we would observe a rising prevalence of MethHF in admitted patients, along with a unique phenotype.
Methods: Among 9588 patients with diagnosis of heart failure treated at San Diego VA Medical Center in between 2005-2015, 480 were identified to have history of methamphetamine abuse as determined by ICD-9 diagnosis code and/or urine toxicology screen as well as a diagnosis code of heart failure. Demographic, diagnostic, and clinical characteristics of MethHF and heart failure patients without methamphetamine use (HF) were compared. Clinical outcomes of time to emergency room (ER) visit, all-cause readmission, and all-cause mortality were compared using Kaplan-Meier curves.
Results: From 2005-2015, the prevalence of methamphetamine usage among patients with heart failure increased linearly (Figure 1). A preliminary cohort comparison demonstrated MethHF had similar ejection fraction and BNP levels but trends toward increased troponin levels, more atrial fibrillation, and a higher GFR. MethHF patients had a greater risk of ER visits (2.3 per year vs 0.5 per year, p=0.01) and a trend towards a greater risk of all-cause hospital readmission (1.3 per year vs 0.6 per year, p=0.09).
MethHF is also more likely to have QTc prolongation, and ventricular dilatation.
Conclusions: Heart failure due to methamphetamine use – or MethHF- is increasing in prevalence and appears to be a new phenotype of heart failure. MethHF and HF differ in multiple domains, including healthcare utilization.
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