Acute myocardial infarction in young adults who abuse amphetamines.
BACKGROUND
Case reports suggest a link between methamphetamine abuse and acute myocardial infarction (AMI), but no epidemiologic studies have examined this link. Our objective was to test the hypothesis that young adults who abuse amphetamines are at higher risk for AMI.


METHODS
In this study of 3,148,165 discharges from Texas hospitals in a quality indicators database during 2000-2003, among persons aged 18-44 years we identified 11,011 AMIs, defined according to the Agency for Healthcare Research and Quality's AMI mortality inpatient quality indicator.


RESULTS
In a multiple logistic regression analysis - while controlling for cocaine abuse, alcohol abuse, tobacco use, hypertension, diabetes mellitus, lipid disorders, obesity, congenital defects, and coagulation defects - amphetamine abuse was significantly associated with AMI (adjusted odds ratio=1.61; 95% CI=1.24-2.04, p=0.0004). The rate of AMIs among amphetamine abusers increased significantly from 2000 to 2003. The population attributable risk suggests that amphetamine abuse is responsible for 0.2% of AMIs in the state of Texas. The geographical distribution of amphetamine abuse varied by region, with the prevalence being highest in the North Texas and Panhandle regions of Texas.


CONCLUSIONS
This modest, though statistically robust, association suggests that amphetamine abuse may play a role in AMI.
Westover
Arthur N
AN
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-8828, USA. arthur.westover@UTSouthwestern.edu <arthur.westover@UTSouthwestern.edu>
Nakonezny
Paul A
PA
Haley
Robert W
RW
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D016015:Logistic Models; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000523:psychology; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology