Abstract 13817: Methamphetamine Use is Common Among Patients with Pulmonary Arterial Hypertension (PAH) in California and is Associated with Worse Long-Term Survival Compared with Idiopathic PAH
Methamphetamine (meth) abuse is a major public health problem in the United States. Meth use has been linked to PAH in up to 30% of cases of idiopathic PAH (IPAH), however there are few studies that have examined this relationship and its impact on survival. We sought to test the hypothesis that characteristics of meth users with IPAH (meth-PAH) are different from other patients with IPAH. We performed a retrospective chart review of all patients seen at the UCSF Pulmonary Hypertension Clinic between January 2008 and 2011. Data was extracted for all patients with a diagnosis of IPAH and meth-PAH. The Mann Whitney test and Fischer’s exact test were used to compare continuous and categorical data, respectively. Survival was compared using Kaplan-Meier analysis. A total of 128 patients were included in the analysis, 56 (44%) with IPAH and 72 (56%) with meth-PAH. Comparison of IPAH vs. meth-PAH showed no significant difference in age (45 vs. 42 years; p=0.17), hemodynamics (mPAP 50 vs. 49 mmHg, p=0.80; CO 4.0 vs. 4.1 L/min p=0.87; RAP 11 vs. 10 mmHg p=0.39), 6MWD (331 vs. 343 m, p=0.6), supplemental oxygen use, use of PDE-5 inhibitors (77% vs. 89%, p=0.08), ERAs (79% vs. 65%, p=0.1), inhaled prostanoids (38% vs. 36%, p=1.0), or combination therapy (77% vs. 72%, p=0.5). Meth-PAH patients were less likely to receive infused prostanoid therapy (38% vs. 59%, p=0.03), and long-term survival was worse compared with IPAH patients (p<0.005). Meth-PAH is very common among patients with PAH in our institution. Most characteristics of patients with meth-PAH are similar to patients with IPAH, however meth-PAH patient are less likely to be treated with infused prostanoid therapies and have worse long-term survival. Observed difference could result from less frequent use of infused prostanoid therapies among active drug users. Further study is needed to understand the cardiovascular consequences of meth use and the safety and efficacy of potentially life-saving PAH therapies in these patients.
- © 2012 by American Heart Association, Inc.