Clinical Correlates and Outcomes of Methamphetamine-Associated Cardiovascular Diseases in Hospitalized Patients in California.
Clinical Correlates and Outcomes of Methamphetamine-Associated Cardiovascular Diseases in Hospitalized Patients in California.
复制标题
加利福尼亚住院患者甲基苯丙胺相关心血管疾病的临床相关因素和结局
DOI：
10.1161/jaha.121.023663
复制
发表时间：
2022-08-16
影响因子：
5.4
通讯作者：
Parikh, Nisha, I
中科院分区：
文献类型：
--
作者：
Curran, Lara;Nah, Gregory;Marcus, Gregory M.;Tseng, Zian;Crawford, Michael H.;Parikh, Nisha, I
关键词：
滥用甲基苯丙胺影响全球2700万人，并与心血管疾病(CVD)有关；然而，吸毒者中CVD的风险因素尚未得到很好的研究。我们研究了2005至2011年间加州的住院患者，这些患者被医疗保健成本和利用项目数据库收集。我们研究了甲基苯丙胺的使用与心血管疾病(肺高压、心力衰竭、中风和心肌梗死)之间的关系。在参与医疗费用和利用项目的20名 249名 026人中，66名 199人使用了甲基苯丙胺(中位数为4.58 年)。与不吸烟者相比，吸烟者更有可能更年轻(33 岁对45 岁)，男性(63.3%对44.4%)，吸烟，滥用酒精，并有抑郁和焦虑。甲基苯丙胺的使用与心力衰竭(危险比，1.53[95%CI，1.45-1.62])和肺动脉高压(HR，1.42[95%CI，1.26-1.60])的发生有关。在使用者中，男性(HR，1.73[95%CI，1.37-2.18])与心肌梗死有关。慢性肾脏疾病(HR，2.38[95%CI，1.74~3.25])和高血压(HR，2.26[95%CI，2.03~2.51])是使用者心血管疾病的重要危险因素。与不使用甲基苯丙胺相比，使用甲基苯丙胺的心血管疾病显著增加32%，滥用酒精的心血管疾病增加28%，使用可卡因的心血管疾病增加47%。使用甲基苯丙胺与酒精和可卡因相比，患心血管疾病的风险类似。预防和治疗可以集中在那些患有慢性肾脏疾病、高血压和精神健康障碍的人。
Methamphetamine misuse affects 27 million people worldwide and is associated with cardiovascular disease (CVD); however, risk factors for CVD among users have not been well studied. We studied hospitalized patients in California, captured by the Healthcare Cost and Utilization Project database, between 2005 and 2011. We studied the association between methamphetamine use and CVD (pulmonary hypertension, heart failure, stroke, and myocardial infarction). Among 20 249 026 persons in the Healthcare Cost and Utilization Project, 66 199 used methamphetamines (median follow‐up 4.58 years). Those who used were more likely younger (33 years versus 45 years), male (63.3% versus 44.4%), smoked, misused alcohol, and had depression and anxiety compared with nonusers. Methamphetamine use was associated with the development of heart failure (hazard ratio [HR], 1.53 [95% CI, 1.45–1.62]) and pulmonary hypertension (HR, 1.42 [95% CI, 1.26–1.60]). Among users, male sex (HR, 1.73 [95% CI, 1.37–2.18]) was associated with myocardial infarction. Chronic kidney disease (HR, 2.38 [95% CI, 1.74–3.25]) and hypertension (HR, 2.26 [95% CI, 2.03–2.51]) were strong risk factors for CVD among users. When compared with nonuse, methamphetamine use was associated with a 32% significant increase in CVD, alcohol abuse with a 28% increase, and cocaine use with a 47% increase in CVD. Methamphetamine use has a similar magnitude of risk of CVD compared with alcohol and cocaine. Prevention and treatment could be focused on those with chronic kidney disease, hypertension, and mental health disorders.