Aortic dissection in young adults who abuse amphetamines.
BACKGROUND
Case reports suggest a relationship between amphetamine abuse/dependence and aortic dissection, but no population-based epidemiologic studies have examined this link. Our objective was to test the hypothesis that young adults with a diagnosis of amphetamine abuse/dependence would be at higher risk for aortic dissection after accounting for known risk factors.


METHODS
In this population-based case-control study of 30,922,098 discharges from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1995 to 2007, among persons aged 18 to 49 years, we identified 3,116 thoracic and thoracoabdominal aortic dissections using International Classification of Disease, Ninth Edition, Clinical Modification codes 441.01 and 441.03. The SURVEYLOGISTIC procedure in SAS 9.2 (SAS Institute, Cary, NC) was used to account for the Nationwide Inpatient Sample sampling methodology.


RESULTS
In a multiple logistic regression analysis, while controlling for known risk factors, amphetamine abuse/dependence was significantly associated with aortic dissection (adjusted odds ratio = 3.33, 95% CI = 2.37-4.69, P < .0001).


CONCLUSIONS
This statistically significant association suggests that amphetamine abuse/dependence may play a role in aortic dissection in young adults in the United States.
Westover
Arthur N
AN
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8828, USA. arthur.westover@utsouthwestern.edu
Nakonezny
Paul A
PA
D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications*; D000784:Aortic Dissection / Q000139:chemically induced / Q000453:epidemiology*; D017545:Aortic Aneurysm, Thoracic / Q000139:chemically induced / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult