Clinical Characteristics and Outcomes of Patients with Heart Failure and Methamphetamine Abuse

Abstract Background Despite a global epidemic of methamphetamine abuse, methamphetamine-associated heart failure (MethHF) remains poorly understood. We sought to evaluate characteristics and outcomes for patients with MethHF. Methods We reviewed the electronic health records of the University of California, San Diego from 2005-16. We compared characteristics and outcomes between 896 patients with MethHF and 20,576 patients with heart failure (HF) identified using diagnosis codes, urine toxicology, and natriuretic peptides. Results Compared to HF, patients with MethHF were younger (50±10 v. 67±16 years), predominantly male (72% v. 54%), and had more psychiatric and substance use co-morbidities, including mood/anxiety disorders (29% v. 16%) and opioid use (44% v. 7%). MethHF had a higher 5-year HF readmission rate [64±4% v. 45±1%; hazard ratio (HR) 1.53, p Conclusions Patients with MethHF are frequently encumbered by psychiatric and substance abuse co-morbidities, and carry a substantial risk of heart failure readmission and mortality. Comprehensive efforts are needed to stem this emerging epidemic.