ANAHEIM, CA – The rate of heart failure associated with methamphetamine (meth) use appears to be on the upswing in veterans, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2017.
The research from the University of California San Diego looked at 9,588 patients at the San Diego VAMC diagnosed with heart failure from 2005 to 2015, determining that 480 of them had a history of meth abuse. Background information in the study notes that more than 4.7% of the U.S. population reports at least one use of the stimulant drug.1
“Methamphetamine (or meth) is one of the most commonly used drugs in the United States, and its use is on the rise. In addition to other health problems associated with the drug, clinicians are seeing more heart failure with meth use, suggesting heart failure due to methamphetamine use could be a new epidemic,” explained study author Marin Nishimura, MD, an internal medicine resident. The prevalence of meth use rose from 1.7% among VA heart failure patients in 2005 to 8% in 2015.
The researchers found significant differences, but also similarities, comparing heart failure patients with and without meth use. While ejection fraction and brain natriuretic peptide (BNP) levels didn’t differ much, meth users were more likely to have increased troponin levels, more atrial fibrillation and higher glomerular filtration rate (GFR) but were less likely to have significant coronary artery disease than non-meth users. The heart failure patients with a history. of meth use also had a greater risk of emergency department visits — 2.3 per year vs 0.5 per year — and a trend towards a greater risk of all-cause hospital readmission — 1.3 per year vs 0.6 per year.
In addition, meth users with heart failure, who averaged 61-years-old, were much younger than heart failure patients in general, with an average age of 72.
One key finding was that the meth users with heart failure were more likely to have psychiatric issues, such as depression and post-traumatic stress disorder (PTSD), study authors pointed out.
“The finding that meth users are more likely to be affected by psychiatric illnesses and tended to require more emergency department visits has important implications because they impact the cost of healthcare and healthcare utilization,” Nishimura explained, adding that those patients might require extra attention from primary care providers to avoid emergency care or hospitalization.
She also called for research on the link between meth use and heart failure, adding, “Our finding is based on a single center and only is based on the very specific population of the veterans in San Diego, so this should be looked at in other populations.”
- Nishimura M, Ma J, Thomas IC. Methamphetamine Associated Heart Failure, a New Epidemic. Poster session presented at the AHA Scientific Sessions 2017, Nov. 11-15, 2017. Anaheim, California.
A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.
When Terrence O’Neil, MD, retired as chief of nephrology at the James H. Quillen VAMC in Johnson City in December 2016, he left in his wake decades of work treating kidney disease—nearly 35 years in the Air Force and DoD, plus 11 more at VA.