Acute myocardial infarction in young adults who abuse amphetamines
Arthur N Westover1, Paul A Nakonezny, Robert W Haley
1Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-8828, USA. arthur.westover@UTSouthwestern.edu <arthur.westover@UTSouthwestern.edu>
Background:
Case reports suggest a link between methamphetamine abuse and acute myocardial infarction (AMI), but no epidemiologic studies have examined this link. Our objective was to test the hypothesis that young adults who abuse amphetamines are at higher risk for AMI.
Methods:
In this study of 3,148,165 discharges from Texas hospitals in a quality indicators database during 2000-2003, among persons aged 18-44 years we identified 11,011 AMIs, defined according to the Agency for Healthcare Research and Quality's AMI mortality inpatient quality indicator.
Results:
In a multiple logistic regression analysis - while controlling for cocaine abuse, alcohol abuse, tobacco use, hypertension, diabetes mellitus, lipid disorders, obesity, congenital defects, and coagulation defects - amphetamine abuse was significantly associated with AMI (adjusted odds ratio=1.61; 95% CI=1.24-2.04, p=0.0004). The rate of AMIs among amphetamine abusers increased significantly from 2000 to 2003. The population attributable risk suggests that amphetamine abuse is responsible for 0.2% of AMIs in the state of Texas. The geographical distribution of amphetamine abuse varied by region, with the prevalence being highest in the North Texas and Panhandle regions of Texas.
Conclusions:
This modest, though statistically robust, association suggests that amphetamine abuse may play a role in AMI.
Insights
Amphetamine abuse is linked to a higher risk of acute myocardial infarction (AMI) in young adults. This study found a significant association, suggesting amphetamine use may contribute to heart attacks.
Area of Science:
- Cardiology
- Public Health
- Addiction Medicine
Background:
- Previous case reports suggested a link between methamphetamine abuse and acute myocardial infarction (AMI).
- No large-scale epidemiologic studies had previously investigated this association.
Purpose of the Study:
- To test the hypothesis that young adults abusing amphetamines have an increased risk of AMI.
- To quantify the association between amphetamine abuse and AMI in a large population.
Main Methods:
- Analysis of 11,011 cases of AMI among persons aged 18-44 years from 3,148,165 hospital discharges in Texas (2000-2003).
- Utilized the Agency for Healthcare Research and Quality's AMI mortality inpatient quality indicator for AMI definition.
- Employed multiple logistic regression analysis, controlling for various cardiovascular risk factors and substance abuse.
Main Results:
- Amphetamine abuse was significantly associated with AMI (adjusted odds ratio=1.61; 95% CI=1.24-2.04, p=0.0004) after controlling for confounders.
- The rate of AMIs among amphetamine abusers showed a significant increase from 2000 to 2003.
- Amphetamine abuse was estimated to be responsible for 0.2% of AMIs in Texas, with highest prevalence in North Texas and Panhandle regions.
Conclusions:
- A statistically robust association exists between amphetamine abuse and AMI in young adults.
- Amphetamine abuse may be a contributing factor to the development of acute myocardial infarction.
- Public health initiatives addressing amphetamine abuse could potentially reduce AMI rates in younger populations.
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