Echocardiographic Findings in Heart Failure Patients With Methamphetamine Use: A Case-Control Study

Jariwal, Roopam; Narang, Vishal K; Raza, Nadia; Mann, Baldeep Kaur; Bhandohal, Janpreet; Valdez, Michael; Win, Theingi Tiffany; Joolhar, Fowrooz; Ghandforoush, Aslan

doi:10.7759/cureus.16170

Cited by 1 publication

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References 17 publications

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“…Prior publications on the association between methamphetamine use and outcomes have demonstrated inconsistent results [4][5][6], and there are limited outcome data which accounts for the demographic differences between methamphetamine users and non-users. Moreover, although cardiac structural changes assessed by a transthoracic echocardiogram (TTE) in methamphetamine users have been described, it remains unclear whether any TTE parameters can predict outcomes in this population [7][8][9].…”

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confidence: 99%

Echocardiographic Parameters and Outcomes in Methamphetamine-Associated Heart Failure: A Propensity Score-Weighted Analysis

et al. 2022

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Background: Methamphetamines are a common cause of systolic heart failure (HF). There are limited data on the prognosis associated with hospitalizations for decompensated HF in the setting of methamphetamine use. We aimed to evaluate patient characteristics and outcomes among patients admitted with decompensated HF who had positive drug screens for amphetamines as well as to determine whether any parameters from transthoracic echocardiogram (TTE) can predict outcomes in this population. Methods:This was a retrospective cohort study of consecutive adult patients admitted to the Loma Linda Medical Center who had an active hospital problem of acute on chronic systolic (or systolic and diastolic) HF from 2013 to 2018. Electronic medical records were mined for relevant patient data. Methamphetamine-associated heart failure (MethHF) group was defined as those with an admission urine drug screen (UDS) that was positive for methamphetamines, whereas non-MethHF was defined by patients with negative methamphetamine on UDS or UDS was not done on physician's discretion. The primary outcomes of the study were 30-day composite outcome (defined as combined all-cause readmission and all-cause mortality), 365-day allcause mortality, and length of stay (LOS). Propensity score weighting for these outcomes was performed using demographics, laboratory and clinical variables, and left ventricular ejection fraction (LVEF) as covariates. TTE parameters from presentation were also evaluated to determine if any had prognostic implications.Results: A total of 1,655 patients were included (101 patients with positive urine methamphetamine and 1,554 patients without). Patients with MethHF were younger, more likely to be male, had fewer comorbidities, had lower LVEF, and were more likely to have right ven-tricular systolic dysfunction. In propensity-weighted analyses, there were no significant differences in LOS, 30-day composite outcome, or 365-day mortality between the MethHF and non-MethHF group in (P > 0.05 for all). Presence of at least moderate tricuspid valve regurgitation (TR) was the only TTE predictor of 30-day composite outcome (odds ratio (OR) = 4.67, 95% confidence interval (CI): 1.5 -14.50, P < 0.01) and 365-day mortality (OR = 4.67, 95% CI: 1.5 -14.50, P < 0.01) in the MethHF group. Conclusion:Patients with MethHF admitted for decompensated HF had similar outcomes compared to non-MethHF after adjusting for baseline characteristics. TR is the only TTE value to predict outcomes in this population.

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