Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors

BackgroundMethamphetamine and cocaine use are known risk factors for heart failure (HF). Previous studies focused on HF cases identified as either methamphetamine or cocaine-induced HF with no study identifying the HF subtype most associated with stimulant use. Our study hypothesizes that stimulant...

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Main Authors: Akshat Agrawal, Brooke Scardino, Diensn G. Xing, Md. Shenuarin Bhuiyan, Rick A. Bevins, Kalgi Modi, Tarek Helmy, Steven A. Conrad, Nicholas E. Goeders, Md Mostafizur Rahman Bhuiyan, John A. Vanchiere, A. Wayne Orr, Christopher G. Kevil, Mohammad Alfrad Nobel Bhuiyan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1566481/full
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author Akshat Agrawal
Brooke Scardino
Diensn G. Xing
Md. Shenuarin Bhuiyan
Md. Shenuarin Bhuiyan
Rick A. Bevins
Kalgi Modi
Tarek Helmy
Steven A. Conrad
Steven A. Conrad
Nicholas E. Goeders
Md Mostafizur Rahman Bhuiyan
John A. Vanchiere
John A. Vanchiere
A. Wayne Orr
A. Wayne Orr
Christopher G. Kevil
Christopher G. Kevil
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
author_facet Akshat Agrawal
Brooke Scardino
Diensn G. Xing
Md. Shenuarin Bhuiyan
Md. Shenuarin Bhuiyan
Rick A. Bevins
Kalgi Modi
Tarek Helmy
Steven A. Conrad
Steven A. Conrad
Nicholas E. Goeders
Md Mostafizur Rahman Bhuiyan
John A. Vanchiere
John A. Vanchiere
A. Wayne Orr
A. Wayne Orr
Christopher G. Kevil
Christopher G. Kevil
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
author_sort Akshat Agrawal
collection DOAJ
description BackgroundMethamphetamine and cocaine use are known risk factors for heart failure (HF). Previous studies focused on HF cases identified as either methamphetamine or cocaine-induced HF with no study identifying the HF subtype most associated with stimulant use. Our study hypothesizes that stimulant users have a higher odds of developing HFrEF than HFpEF. Our study also compares demographic and comorbidities between the HF subtypes.MethodsNational Inpatient Sample data from 2008 to 2020 were used to identify hospital admissions among stimulant users with HF. The chi-square test for categorical variables and t-test for continuous variables was used for the weighted sample. P-value was found by linear trend analysis. The trend stratified by age, sex, race, and United States region (defined by the US Census Bureau) was analyzed by the Cochran-Armitage trend test. A generalized linear model determined the HF subtype related to stimulant use adjusted for traditional risk factors, and another model estimated vulnerable patient characteristics.ResultsStimulant use was more likely to be associated with HFrEF (OR = 1.97, CI 1.93–2.01), while less associated with HFpEF (OR = 0.96, CI 0.94–0.98). HF among stimulant users was common (p < 0.001) in males, those aged 41–64, Black patients, Medicaid users, those in the <50 percentile income, and the South or West regions. Stimulant-related HF hospitalizations increased significantly from 2008 to 2020 for all subcategories (p < 0.001).  ConclusionStimulant use is positively associated with HFrEF, with the highest risk being in those middle-aged, male, Black, or covered by Medicaid. The higher likelihood of traditional risk factors for HF in stimulant-related HF supports the hypothesis that stimulants induce multifactorial damage to the cardiovascular system.
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spelling doaj-art-2e523458bf394ed3919d1f4d0a920f1b2025-08-20T03:31:11ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.15664811566481Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factorsAkshat Agrawal0Brooke Scardino1Diensn G. Xing2Md. Shenuarin Bhuiyan3Md. Shenuarin Bhuiyan4Rick A. Bevins5Kalgi Modi6Tarek Helmy7Steven A. Conrad8Steven A. Conrad9Nicholas E. Goeders10Md Mostafizur Rahman Bhuiyan11John A. Vanchiere12John A. Vanchiere13A. Wayne Orr14A. Wayne Orr15Christopher G. Kevil16Christopher G. Kevil17Mohammad Alfrad Nobel Bhuiyan18Mohammad Alfrad Nobel Bhuiyan19Mohammad Alfrad Nobel Bhuiyan20Department of Public Health, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pediatrics, LSU Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pediatric Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshDepartment of Pediatrics, LSU Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesDepartment of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesLouisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United StatesBackgroundMethamphetamine and cocaine use are known risk factors for heart failure (HF). Previous studies focused on HF cases identified as either methamphetamine or cocaine-induced HF with no study identifying the HF subtype most associated with stimulant use. Our study hypothesizes that stimulant users have a higher odds of developing HFrEF than HFpEF. Our study also compares demographic and comorbidities between the HF subtypes.MethodsNational Inpatient Sample data from 2008 to 2020 were used to identify hospital admissions among stimulant users with HF. The chi-square test for categorical variables and t-test for continuous variables was used for the weighted sample. P-value was found by linear trend analysis. The trend stratified by age, sex, race, and United States region (defined by the US Census Bureau) was analyzed by the Cochran-Armitage trend test. A generalized linear model determined the HF subtype related to stimulant use adjusted for traditional risk factors, and another model estimated vulnerable patient characteristics.ResultsStimulant use was more likely to be associated with HFrEF (OR = 1.97, CI 1.93–2.01), while less associated with HFpEF (OR = 0.96, CI 0.94–0.98). HF among stimulant users was common (p < 0.001) in males, those aged 41–64, Black patients, Medicaid users, those in the <50 percentile income, and the South or West regions. Stimulant-related HF hospitalizations increased significantly from 2008 to 2020 for all subcategories (p < 0.001).  ConclusionStimulant use is positively associated with HFrEF, with the highest risk being in those middle-aged, male, Black, or covered by Medicaid. The higher likelihood of traditional risk factors for HF in stimulant-related HF supports the hypothesis that stimulants induce multifactorial damage to the cardiovascular system.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1566481/fullstimulantHFpEFHFrEFtrenddisparity
spellingShingle Akshat Agrawal
Brooke Scardino
Diensn G. Xing
Md. Shenuarin Bhuiyan
Md. Shenuarin Bhuiyan
Rick A. Bevins
Kalgi Modi
Tarek Helmy
Steven A. Conrad
Steven A. Conrad
Nicholas E. Goeders
Md Mostafizur Rahman Bhuiyan
John A. Vanchiere
John A. Vanchiere
A. Wayne Orr
A. Wayne Orr
Christopher G. Kevil
Christopher G. Kevil
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
Mohammad Alfrad Nobel Bhuiyan
Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
Frontiers in Cardiovascular Medicine
stimulant
HFpEF
HFrEF
trend
disparity
title Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
title_full Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
title_fullStr Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
title_full_unstemmed Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
title_short Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors
title_sort hospitalized patients and stimulant use associated heart failure importance of ejection fraction and related risk factors
topic stimulant
HFpEF
HFrEF
trend
disparity
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1566481/full
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