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A Comprehensive Approach to Managing Methamphetamine-Associated Cardiomyopathy

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A Letter to the Editor to this article was published on 21 June 2022

Abstract

Methamphetamines are illicit drugs of the amphetamine-type stimulant class that have been increasing in popularity, availability, and purity in recent decades. As a result, rates of methamphetamine-associated cardiomyopathy (MAC) are rising globally. MAC is associated with high rates of sudden cardiac arrest, late presentation, and poor outcomes. This review discusses the medical management of MAC, including anticipated challenges specific to methamphetamine users. Not only are patients with MAC more likely to present at a younger age and with multisystem disease than patients with cardiomyopathy of other etiologies, but there may also be significant behavioral, psychosocial, financial, and system-based challenges to providing the best medical care. An individualized treatment plan that emphasizes methamphetamine abstinence as the foundation of therapy, as well as introducing optimal heart failure therapy and providing multidisciplinary support is likely to result in optimal outcomes. Given the potential reversibility of MAC, institution of guideline-directed heart failure therapy and patient support for adherence to therapy and abstinence from methamphetamines should be energetically pursued.

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Authors and Affiliations

  1. St Vincent’s Hospital Melbourne, Fitzroy, VIC, 3065, Australia

    Michael Osekowski, Adam Trytell, Andre La Gerche, David Prior, Andrew MacIsaac & Elizabeth D. Paratz

  2. National Centre for Sports Cardiology, Fitzroy, VIC, Australia

    Andre La Gerche & David Prior

  3. Baker Heart and Diabetes Institute, Prahran, VIC, Australia

    Andre La Gerche & Elizabeth D. Paratz

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  1. Michael Osekowski
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  2. Adam Trytell
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Correspondence to Elizabeth D. Paratz.

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Michael Osekowski, Adam Trytell, Andre La Gerche, David Prior, Andrew MacIsaac, and Elizabeth Paratz have no conflicts of interest that are directly relevant to the content of this article.

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Osekowski, M., Trytell, A., La Gerche, A. et al. A Comprehensive Approach to Managing Methamphetamine-Associated Cardiomyopathy. Am J Cardiovasc Drugs 22, 385–393 (2022). https://doi.org/10.1007/s40256-022-00523-y

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