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Updated: Sep 15, 2025
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk
Akshat Agrawal1, Brooke Scardino2, Diensn G Xing2
1Department of Public Health, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States.
Insights
Stimulant use, including methamphetamine and cocaine, is linked to a higher risk of heart failure with reduced ejection fraction (HFrEF). This study found stimulant users are more likely to develop HFrEF than HFpEF.
Area of Science:
- Cardiology
- Public Health
- Toxicology
Background:
- Stimulant use (methamphetamine, cocaine) is a known risk factor for heart failure (HF).
- Previous research has not specified HF subtypes associated with stimulant use.
- This study investigates the association between stimulant use and HF subtypes, specifically HFrEF versus HFpEF.
Purpose of the Study:
- To test the hypothesis that stimulant users have a higher likelihood of developing HFrEF compared to HFpEF.
- To compare demographic characteristics and comorbidities between HF subtypes in stimulant users.
- To identify patient populations at higher risk for stimulant-related HF.
Main Methods:
- Utilized National Inpatient Sample data from 2008-2020 for hospital admissions of stimulant users with HF.
- Employed chi-square and t-tests for categorical and continuous variables, respectively.
- Used generalized linear models to determine HF subtype association with stimulant use, adjusting for traditional risk factors.
Main Results:
- Stimulant use showed a higher association with HFrEF (OR=1.97) than HFpEF (OR=0.96).
- HF among stimulant users was prevalent in males, aged 41-64, Black patients, Medicaid users, lower income groups, and in the South/West regions.
- Stimulant-related HF hospitalizations significantly increased from 2008-2020 across all subcategories.
Conclusions:
- Stimulant use is positively associated with HFrEF, particularly in middle-aged, male, Black individuals, and those with Medicaid.
- The increased prevalence of traditional HF risk factors in stimulant-related HF supports multifactorial cardiovascular damage.
- Findings highlight specific demographic groups at elevated risk for stimulant-associated heart failure.
Background:
Methamphetamine and cocaine use are known risk factors for heart failure (HF). Previous studies focused on HF cases identified as either methamphetamine or cocaine-induced HF with no study identifying the HF subtype most associated with stimulant use. Our study hypothesizes that stimulant users have a higher odds of developing HFrEF than HFpEF. Our study also compares demographic and comorbidities between the HF subtypes.
Methods:
National Inpatient Sample data from 2008 to 2020 were used to identify hospital admissions among stimulant users with HF. The chi-square test for categorical variables and t-test for continuous variables was used for the weighted sample. P-value was found by linear trend analysis. The trend stratified by age, sex, race, and United States region (defined by the US Census Bureau) was analyzed by the Cochran-Armitage trend test. A generalized linear model determined the HF subtype related to stimulant use adjusted for traditional risk factors, and another model estimated vulnerable patient characteristics.
Results:
Stimulant use was more likely to be associated with HFrEF (OR = 1.97, CI 1.93-2.01), while less associated with HFpEF (OR = 0.96, CI 0.94-0.98). HF among stimulant users was common (p < 0.001) in males, those aged 41-64, Black patients, Medicaid users, those in the <50 percentile income, and the South or West regions. Stimulant-related HF hospitalizations increased significantly from 2008 to 2020 for all subcategories (p < 0.001). .
Conclusion:
Stimulant use is positively associated with HFrEF, with the highest risk being in those middle-aged, male, Black, or covered by Medicaid. The higher likelihood of traditional risk factors for HF in stimulant-related HF supports the hypothesis that stimulants induce multifactorial damage to the cardiovascular system.
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