Author + information
- Susan X. Zhao, MDa,∗ (, )
- Calvin Kwong, MDb,
- Aravind Swaminathan, MDa,
- Amit Gohil, MDc and
- Michael H. Crawford, MDd
- aDivision of Cardiology, Santa Clara Valley Medical Center, San Jose, California
- bDepartment of Medicine, Santa Clara Valley Medical Center, San Jose, California
- cDivision of Pulmonary and Critical Care Medicine, Santa Clara Valley Medical Center, San Jose, California
- dDivision of Cardiology, University of California-San Francisco, San Francisco, California
- ↵∗Address for correspondence:
Dr. Susan X. Zhao, Santa Clara Valley Medical Center, 751 S. Bascom Avenue, Suite 340, San Jose, California 95128.
Objectives This study sought to characterize patients with methamphetamine-associated pulmonary arterial hypertension (MA-PAH) and cardiomyopathy (MA-CMP), to compare with MA controls (MA-CTL), users with structurally normal hearts, with the aim of identifying risk factors for these conditions.
Background MA-PAH and MA-CMP are 2 poorly understood cardiac complications in MA users.
Methods We retrospectively studied the clinical characteristics and outcomes of 50 MA-PAH, 296 MA-CMP, and 356 MA-CTL patients, whom we evaluated between 2010 and 2017.
Results After a median follow-up of 20.0 months (interquartile range [IQR]: 7.6 to 42.6 months), all-cause mortality was 18.0% for MA-PAH, 15.2% for MA-CMP, and 4.5% for MA-CTL group (p < 0.001). More women (58%) were in the MA-PAH group than in the MA-CMP (14%; p < 0.001) and MA-CTL (42%; p = 0.028) groups, whereas the MA-CMP group was predominantly male (86% vs. 58% in the MA-CTL group; p < 0.001). More MA-CMP patients had hypertension (p < 0.001) or alcoholism (p < 0.001) than MA-CTL patients. Logistic regression analyses identified male sex, alcoholism, and hypertension as independent factors associated with MA-CMP with the following respective adjusted odds ratios (OR) of 3.791 (95% confidence interval [CI]: 2.508 to 5.730), OR of 2.959 (95% CI: 2.084 to 4.203), and OR of 2.111 (95% CI: 1.486 to 2.999), whereas female sex was the only factor associated with MA-PAH.
Conclusions Both MA-PAH and MA-CMP patients carried significant disease burden and mortality risk. Male sex, hypertension, and alcoholism were strongly associated with MA-CMP, whereas female sex and other unknown factors may influence development of MA-PAH. This study adds to the understanding of MA-associated cardiac complications and highlights directions for future investigation.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 14, 2017.
- Revision received October 5, 2017.
- Accepted October 7, 2017.
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