Summary: | Amphetamine is the most commonly used illicit drug in Saudi Arabia (SA). Frequency and outcome of Amphetamine-related cardiovascular (CV) complications in Saudi Arabia have not been previously studied.
Aim: To determine the epidemiological aspects and clinical outcomes of the cardiovascular complications among individuals with Amphetamine-Positive Urine Drug Screening (APUDS) who were admitted to a large tertiary care facility in Riyadh, SA.
Methods: Retrospective, case-series review of consecutive individuals found to have APUDS and admitted to King Abdul-Aziz Medical City (KAMC) in Riyadh, SA between January 2006 through December 2013 inclusive. Cases with APUDS and concurrent positive cardiac biomarkers and/or admission to a cardiology unit were enrolled in the review. Demographic and clinical data were collected from electronic patient records. All data variables were managed and analyzed by Microsoft-Excel and IBM-SPSS software, version 20.
Results: A total of 7450 UDS were performed during the study period, out of which 720 (9.6%) were positive for Amphetamine. Forty-two admissions with APUDS were documented to have CV complications. All cases were males with a mean age of 41 ± 10 years and predominantly Saudis. Acute Coronary Syndrome (ACS) was the most frequent clinical presentation (n = 31, 73.8%), predominantly of ST Elevation Myocardial Infarction (STEMI) type. Other less frequent complications include myoperecarditis and cardiomyopathy. Coronary procedures were performed in 30 cases. Average hospital stay was 7 days and in-hospital mortality was 7.2%.
Conclusions and Recommendations: ACS is the most frequent CV complication in the Amphetamine users. Amphetamine-related CV complications tend to occur at younger age and carry high risk of in-hospital mortality. UDS should be performed routinely for all individuals presenting with acute coronary syndrome or heart failure at young age. Confirmatory test should be routine available as a standard of care.
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