Is methamphetamine use associated with idiopathic pulmonary arterial hypertension?
Is methamphetamine use associated with idiopathic pulmonary arterial hypertension?
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DOI：
10.1378/chest.130.6.1657
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发表时间：
2006-12-01
期刊：
影响因子：
9.6
通讯作者：
Rubin, Lewis J.
中科院分区：
文献类型：
--
作者：
Chin, Kelly M.;Channick, Richard N.;Rubin, Lewis J.
背景资料：安非他明、甲基苯丙胺和可卡因被怀疑是肺动脉高压的危险因素，这是基于少量病例报告，沿着与芬氟拉明（一种与肺动脉高压（PAH）相关的减肥药）的药理学相似性。我们试图确定与PAH和已知危险因素患者以及慢性血栓栓塞性肺动脉高压（CTEPH）患者相比，特发性PAH患者的兴奋剂使用率是否增加。在这项回顾性研究中，确定了340例特发性PAH、PAH和已知风险因素患者的兴奋剂使用率，或2002年11月至2004年4月期间发生的CTEPH。“兴奋剂”使用被定义为任何报告的安非他明、甲基安非他明或可卡因的使用。兴奋剂使用的赔率计算使用multichotomous logistic regression model.Results：兴奋剂使用的历史被发现在28.9%的诊断为特发性PAH的患者，相比之下，3.8%的PAH患者和一个已知的危险因素，和4.3%的CTEPH患者。调整年龄差异后，特发性PAH患者为10.14倍（95%置信区间，3.39至30.3; p < 0.0001）使用兴奋剂的可能性比PAH和已知风险因素的患者高，是PAH和已知风险因素患者的7.63倍。（95%可信区间，2.99 ~ 19.5; p < 0.0001）与CTEPH.Conclusions患者相比，特发性PAH患者使用兴奋剂的可能性更大。
Background: Amphetamine, methamphetamine, and cocaine are suspected of being pulmonary hypertension risk factors based on a small number of case reports along with pharmacologic similarities to fenfluramine, a diet drug associated with pulmonary arterial hypertension (PAH). We sought to determine whether rates of stimulant use are increased in patients believed to have idiopathic PAH compared with patients with PAH and known risk factors and patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods: In this retrospective study, rates of stimulant use were determined for 340 patients with idiopathic PAH, PAH and known risk factors, or CTEPH seen between November 2002 and April 2004. "Stimulant" use was defined as any reported use of amphetamine, methamphetamine, or cocaine. Odds of stimulant use were calculated using a polychotomous logistic regression model.Results: A history of stimulant use was found in 28.9% of patients with a diagnosis of idiopathic PAH, compared with 3.8% of patients with PAH and a known risk factor, and 4.3% of patients with CTEPH. After adjustment for differences in age, patients with idiopathic PAH were 10.14 times (95% confidence interval, 3.39 to 30.3; p < 0.0001) more likely to have used stimulants than patients with PAH and known risk factors, and 7.63 times (95% confidence interval, 2.99 to 19.5; p < 0.0001) more likely to have used stimulants than patients with CTEPH.Conclusions: Patients with idiopathic PAH are significantly more likely to have used stimulants than patients with other forms of pulmonary hypertension.