Risk of Cardiovascular Diseases and Stroke Events in Methamphetamine Users: A 10-Year Follow-Up Study

J Clin Psychiatry. 2016 Oct;77(10):1396-1403. doi: 10.4088/JCP.15m09872.

Abstract

Objective: Long-term follow-up data regarding the association between methamphetamine use and cardiovascular and cerebrovascular complications are scarce. We investigated the risk of complications in methamphetamine users over a decade.

Methods: A total of 1,315 inpatients treated for methamphetamine use were recruited from the Psychiatric Inpatient Medical Claims database in Taiwan between January 1, 1997, and December 31, 2000, and matched with a population proxy comparison group at a ratio of 1:4 through propensity score matching. All patients were monitored for any incident complication until December 31, 2010. Cox proportional hazards model was used to estimate the risk of ICD-9-CM cardiovascular diseases and stroke events.

Results: The patients were mostly male, and approximately half were younger than 30 years. The methamphetamine cohort had higher incidences of cardiovascular diseases and stroke events than the comparison cohort (87.5/10,000 vs 55.3/10,000 person-years, P < .001) and was significantly associated with an increased risk of the complications (hazard ratio [HR] = 1.55, P < .001), particularly arrhythmia (HR = 1.92, P = .014) and hemorrhagic stroke (HR = 2.09, P = .001). The risk of cardiovascular sequelae was more significant in younger patients (< 30 y) (HR = 2.22, P = .001), whereas the risk of stroke events was higher among the older patients (≥ 30 y) (HR = 1.86, P = .001).

Conclusions: Methamphetamine use is significantly associated with a risk of subsequent cardiovascular and cerebrovascular complications. Age appears to be an effect modifier for the risk estimation.

MeSH terms

  • Adult
  • Aged
  • Amphetamine-Related Disorders / complications*
  • Amphetamine-Related Disorders / epidemiology
  • Amphetamine-Related Disorders / rehabilitation
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology
  • Central Nervous System Stimulants / adverse effects*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Methamphetamine / adverse effects*
  • Middle Aged
  • Proportional Hazards Models
  • Risk
  • Stroke / chemically induced*
  • Stroke / epidemiology
  • Taiwan
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methamphetamine