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 Some previous research in animals and humans has tied meth abuse to
a variety of serious or potentially fatal cardiovascular problems
including heart failure, as well as damage to blood vessels in the
brain, stroke, high blood pressure and irregular heartbeat. But
research to date hasn’t offered a clear picture of what happens to
the heart once methamphetamine use stops.
For the current study, researchers examined data on 30 meth users in
Germany with evidence of heart failure. After an average follow-up
of almost three years, the 23 users who quit during the study were
less likely to die, have a stroke or be hospitalized for heart
failure than the seven continuing meth users, although the study was
too small to rule out the possibility that these differences were
due to chance.
“We can see that suspending use of methamphetamine appears to lead
to a reversal of heart failure in a good number of patients that are
affected in this way,” said Dr. James Januzzi, Jr. of Harvard
Medical School and the Massachusetts General Hospital Heart Center
in Boston.
“This recovery is a most important finding, and illustrates the
importance of abstinence, not only in the short term to improve
heart function, but also longer-term to avoid risk for return of
heart dysfunction and death from heart failure,” Januzzi, author of
an editorial accompanying the study in JACC: Heart Failure, said by
email.
At the start of the study, patients were typically around 30 years
old and had been abusing meth for almost six years, though the
duration of drug use ranged from one to 15 years.
Imaging tests done at the beginning of the study found that all of
them had what’s known as severely impaired left ventricular ejection
fraction, a reduced ability to send blood out into the body from the
main pumping chamber of the heart that is a hallmark of heart
failure.
Many patients also had shortness of breath or difficulty breathing,
heart valve damage, blood clots, palpitations or a chronic cough.
During the study, patients received treatments tailored to their
specific heart issues that included surgically implanted or
externally worn defibrillators to establish a normal heart beat as
well as drugs to manage blood pressure, reduce fluid buildup and
prevent clotting.
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Two patients who quit meth and one who continued to abuse the drug
died during the study.
Roughly 57 percent of continuing meth users died, had a non-fatal
stroke or a repeat hospitalization for heart failure during the
study, compared with about 17 percent of the people who stopped meth
use.
Limitations of the study include the possibility that some
participants didn’t take medications as prescribed, which might have
influenced how much their heart function improved, the authors note.
And, because the study only included people with heart failure and
impaired cardiac function, it’s not clear if the quitting can
prevent damage in meth users who haven’t developed heart problems.
“There seems to be a ‘point of no return’ characterized by severe
fibrosis (thickening of the heart valves and muscle) which seems to
be associated with irreversible changes,” said lead study author Dr.
Norman Mangner of the University of Leipzig in Germany.
Giving meth addicts treatment to help them quit and treatment for
any underlying heart problems tied to the drug abuse are both
important for reversing heart damage, Mangner said by email.
“Only a withdrawal treatment combined with optimal medical therapy
seems to be adequate to treat patients with methamphetamine
associated (heart damage),” Mangner said.
SOURCE: http://bit.ly/2rkIKIY and http://bit.ly/2rpcYwz JACC Heart
Failure, online May 29, 2017.
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