May 31, 2017 / 7:48 PM / 2 months ago

Meth users who quit may reverse some heart damage

4 Min Read

(Reuters Health) - With the right treatments, some methamphetamine users who kick the habit might be able to undo heart damage linked to abusing these drugs, a small study suggests.

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.

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: bit.ly/2rkIKIY and bit.ly/2rpcYwz JACC Heart Failure, online May 29, 2017.

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