Russell C Callaghan1, Montana Halliday2, Jodi Gatley3, Jenna Sykes4, Lawren Taylor5, Claire Benny6, Stephen J Kish7. 1. Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, BC V2N 4Z9, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 33 Russell St., Toronto, ON M5S 2S1, Canada; Canadian Institute for Substance Use Research, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada. Electronic address: russ.callaghan@unbc.ca. 2. Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, BC V2N 4Z9, Canada. 3. Communicable Diseases, Emergency Preparedness and Response Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON M5G 1V2, Canada. 4. St. Michael's Hospital, 30 Bond St, Toronto, ON M5 B 1W8, Canada. 5. Work Stress and Health Service, Centre for Addiction and Mental Health (CAMH),455 Spadina Avenue, Suite 210, Toronto, ON M5S 2G8, Canada. 6. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada. 7. Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 33 Russell St., Toronto, ON M5S 2S1, Canada.
Abstract
BACKGROUND: It is assumed that recreational use of methamphetamine can trigger acute myocardial infarction (AMI) events, but estimates of longitudinal hazards of AMI among methamphetamine users are lacking. METHODS: Retrospective cohort study: Competing-risks analysis was used to estimate time-to-AMI patterns in methamphetamine versus matched appendicitis (population-proxy) and matched cocaine (drug-control) groups. Cohorts were propensity-score-matched using demographic and clinical variables. SETTING: California, 1990-2005. PARTICIPANTS: Cohorts of individuals with no prior or concurrent history of AMI hospitalized with methamphetamine- (n = 73,056), cocaine- (n = 47,726), or appendicitis-related conditions (n = 330,109). MEASUREMENTS: ICD-9/ICD-10 indications of AMI (ICD-9 410.X; ICD-10 I21.X) in death records or inpatient hospital data. RESULTS: Patients in methamphetamine cohort were more likely to develop subsequent AMI in comparison to those in matched appendicitis cohort [Hazard ratio (HR): 1.41; 95% CI, 1.23-1.62, p < 0.0001], with increased risk most marked in young methamphetamine users (age 15-34 years; HR: 2.04; 95% CI, 1.63-2.57, p = 0. 0001). Risk was slightly increased vs. that in matched cocaine group (HR: 1.19; 95% CI, 1.02-1.39, p = 0. 029). Individuals in cocaine cohort were also more likely to experience AMI outcome vs. appendicitis cohort (HR: 1.25; 95% CI, 1.08-1.45, p = 0. 0023). CONCLUSION: Our longitudinal data support results of earlier epidemiological studies suggesting that persons with methamphetamine- (or cocaine-) use disorders might have increased AMI risk. However, because of potential study limitations and the unexpectedly modest magnitude of the observed increased AMI hazard, these findings must be considered preliminary and require replication.
BACKGROUND: It is assumed that recreational use of methamphetamine can trigger acute myocardial infarction (AMI) events, but estimates of longitudinal hazards of AMI among methamphetamine users are lacking. METHODS: Retrospective cohort study: Competing-risks analysis was used to estimate time-to-AMI patterns in methamphetamine versus matched appendicitis (population-proxy) and matched cocaine (drug-control) groups. Cohorts were propensity-score-matched using demographic and clinical variables. SETTING: California, 1990-2005. PARTICIPANTS: Cohorts of individuals with no prior or concurrent history of AMI hospitalized with methamphetamine- (n = 73,056), cocaine- (n = 47,726), or appendicitis-related conditions (n = 330,109). MEASUREMENTS: ICD-9/ICD-10 indications of AMI (ICD-9 410.X; ICD-10 I21.X) in death records or inpatient hospital data. RESULTS:Patients in methamphetamine cohort were more likely to develop subsequent AMI in comparison to those in matched appendicitis cohort [Hazard ratio (HR): 1.41; 95% CI, 1.23-1.62, p < 0.0001], with increased risk most marked in young methamphetamine users (age 15-34 years; HR: 2.04; 95% CI, 1.63-2.57, p = 0. 0001). Risk was slightly increased vs. that in matched cocaine group (HR: 1.19; 95% CI, 1.02-1.39, p = 0. 029). Individuals in cocaine cohort were also more likely to experience AMI outcome vs. appendicitis cohort (HR: 1.25; 95% CI, 1.08-1.45, p = 0. 0023). CONCLUSION: Our longitudinal data support results of earlier epidemiological studies suggesting that persons with methamphetamine- (or cocaine-) use disorders might have increased AMI risk. However, because of potential study limitations and the unexpectedly modest magnitude of the observed increased AMI hazard, these findings must be considered preliminary and require replication.