Frequency of Methamphetamine Use as a Major Contributor Toward the Severity of Cardiomyopathy in Adults ≤50 Years

Neeki, Michael; Kulczycki, Michael; Toy, Jake; Dong, Fanglong; Lee, Carol; Borger, Rodney; Adigopula, Sasikanth

doi:10.1016/j.amjcard.2016.05.057

Cited by 52 publications

(38 citation statements)

References 18 publications

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“…Ageing may also be a factor in the lower rate of blunt trauma from car and motorcycle collisions seen from our analysis; the traffic collision rate has been shown to decline with age as older drivers may be more skilled and have higher risk aversion compared to younger drivers [ 45 ]. Chronic MAP use has been associated with ACS and the development of cardiomyopathy, which may also be reflected by a trend towards higher age and ED presentations of chest pain in our study, which more than doubled in 2016 compared to 1996 [ 28 , 46 ].…”

Section: Discussionmentioning

confidence: 84%

Methamphetamine Use and Emergency Department Utilization: 20 Years Later

Richards

Hamidi

Grant

et al. 2017

Journal of Addiction

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Background Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed. Methods Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED. Results 638 MAP-positive patients, 3,013 toxicology screens, and 20,203 ED visits represented an increase in prevalence compared to 1996: 461 MAP-positive patients, 3,102 screens, and 32,156 visits. MAP patients were older compared to the past. Mode of arrival was most frequently by ambulance but at a lower proportion than 1996, as was the proportion of MAP patients with positive cocaine toxicology screens and ethanol coingestion. Admission rate was lower compared to the past, as was discharge to jail. The proportion of MAP patients presenting with blunt trauma was lower compared to the past and higher for chest pain. Conclusion A significant increase in the prevalence of MAP-positive patients was found. Differences in presenting complaints and resource utilization may reflect the shifting demographics of MAP users, as highlighted by an older patient population relative to the past.

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Section: Discussionmentioning

confidence: 84%

Methamphetamine Use and Emergency Department Utilization: 20 Years Later

Richards

Hamidi

Grant

et al. 2017

Journal of Addiction

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“…According to the 2015 National Survey on Drug Use and Health, 6% of survey respondents over 26 years of age reported using methamphetamine at some point during their life time [1]. Methamphetamine abuse is associated with an increased risk of adverse cardiovascular events including stroke [2, 3], cardiac arrhythmias [2, 4], subarachnoid and intracerebral hemorrhage [3], and methamphetamine-induced cardiomyopathy [5, 6]. Methamphetamine can also induce myocardial ischemia leading to a heart attack [7–10].…”

Section: Introductionmentioning

confidence: 99%

Repeated exposure to methamphetamine induces sex-dependent hypersensitivity to ischemic injury in the adult rat heart

et al. 2017

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BackgroundWe previously reported that adult female, but not male rats that were prenatally exposed to methamphetamine exhibit myocardial hypersensitivity to ischemic injury. However, it is unknown whether hypersensitivity to ischemic injury develops when rats are exposed to methamphetamine during adulthood. The goal of this study was to determine whether methamphetamine exposure during adulthood sensitizes the heart to ischemic injury.MethodsAdult male and female rats received daily injections of methamphetamine (5 mg/kg) or saline for 10 days. Their hearts were isolated on day 11 and subjected to a 20 min ischemic insult on a Langendorff isolated heart apparatus. Cardiac contractile function was measured by an intraventricular balloon, and infarct size was measured by triphenyltetrazolium chloride staining.ResultsHearts from methamphetamine-treated females exhibited significantly larger infarcts and suppressed postischemic recovery of contractile function compared to hearts from saline-treated females. In contrast, methamphetamine had no effect on infarct size or contractile recovery in male hearts. Subsequent experiments demonstrated that hypersensitivity to ischemic injury persisted in female hearts following a 1 month period of abstinence from methamphetamine. Myocardial protein kinase C-ε expression, Akt phosphorylation, and ERK phosphorylation were unaffected by adult exposure to methamphetamine.ConclusionsExposure of adult rats to methamphetamine sex-dependently increases the extent of myocardial injury following an ischemic insult. These data suggest that women who have a heart attack might be at risk of more extensive myocardial injury if they have a recent history of methamphetamine abuse.

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“…To date, no study has presented witnesses’ reports of fatal methamphetamine toxicity, which may provide information suggestive of a typical presentation. In addition, the known effects of chronic methamphetamine‐induced hypertension on the cardiovascular system (e.g., cardiomegaly, left ventricular hypertrophy, and cardiac fibrosis) are all likely to increase the propensity for methamphetamine‐induced cardiac arrhythmia, making background cardiovascular disease a relevant factor . How common such pathology is in methamphetamine toxicity cases, or how it compares to cases attributed to multiple drug toxicity, is also undocumented.…”

mentioning

confidence: 99%

Clinical and Autopsy Characteristics of Fatal Methamphetamine Toxicity in Australia

Darke

Duflou

Lappin

et al. 2017

Journal of Forensic Sciences

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Characteristics of death attributed solely to methamphetamine toxicity (MT, n = 93) by forensic pathologists were examined and compared to cases of multiple drug toxicity (MDT, n = 634). The mean age of MT cases was 36.7 years, and 86.0% were male. Strenuous activity was reported in 12.9%. The most common witness observations were: collapse (60.3%), difficulty in breathing (36.2%), and hyperthermia (27.6%). MT cases had higher blood methamphetamine (0.54 vs. 0.11 mg/L) and amphetamine (0.04 vs. 0.02 mg/L) concentrations and lower likelihoods for opioids (12.5% vs. 80.9%), hypnosedatives (27.3 vs. 60.7%), antidepressants (14.8 vs. 29.8%), and antipsychotics (9.1 vs. 19.7%). MT cases had significantly heavier hearts than MDT cases (423.4 vs. 385.8 g) and were more likely to have cardiomegaly (37.1 vs. 20.4%) and replacement fibrosis (25.7 vs. 14.5%). The clinical picture was of a sudden cardiac event in a middle-aged man with a high methamphetamine concentration. Cardiovascular signs of heavy methamphetamine use are frequently seen.

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Frequency of Methamphetamine Use as a Major Contributor Toward the Severity of Cardiomyopathy in Adults ≤50 Years

Cited by 52 publications

References 18 publications

Methamphetamine Use and Emergency Department Utilization: 20 Years Later

Methamphetamine Use and Emergency Department Utilization: 20 Years Later

Repeated exposure to methamphetamine induces sex-dependent hypersensitivity to ischemic injury in the adult rat heart

Clinical and Autopsy Characteristics of Fatal Methamphetamine Toxicity in Australia

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