Methamphetamine-associated pulmonary arterial hypertension: data from the national biological sample and data repository for pulmonary arterial hypertension (PAH Biobank)

• Published in: BMJ open respiratory research 2023-12, Vol.10 (1), p.e001917
• Main Authors: Charoenpong, Prangthip, Dhillon, Navneet, Murnane, Kevin, Goeders, Nicholas, Hall, Nicole, Keller, Courtney, Bhuiyan, Mohammad Alfrad Nobel, Walter, Robert
• Format: Article
• Language: English
• Subjects: Amphetamines; Biobanks; Biological Specimen Banks; Case reports; Catecholamines; Clinical Epidemiology; Comparative analysis; Connective tissue diseases; Cross-Sectional Studies; Drug induced Lung Disease; Familial Primary Pulmonary Hypertension - complications; Female; Females; Gender differences; Health sciences; Hemodynamics; Humans; Hypertension, Pulmonary - epidemiology; Hypertension, Pulmonary - etiology; Hypotheses; Hypothesis testing; Male; Methamphetamine; Patient Outcome Assessment; Primary Pulmonary Hypertension; Pulmonary Arterial Hypertension - chemically induced; Pulmonary Arterial Hypertension - complications; Pulmonary Arterial Hypertension - epidemiology; Pulmonary arteries; Pulmonary hypertension; Pulmonary Vasculature; Rare lung diseases; Review boards; Sexes
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2023-001917

ObjectiveThis study compares the clinical and haemodynamic severity of methamphetamine-associated pulmonary arterial hypertension (MA-PAH) with idiopathic pulmonary arterial hypertension (IPAH) and connective tissue-associated pulmonary arterial hypertension (CTD-PAH). It also examines sex differences in clinical and physiological parameters among those with MA-PAH.DesignThis is a cross-sectional study using clinically derived data from the National Biological Sample and Data Repository for Pulmonary Arterial Hypertension (PAH biobank), a US-based registry, to compare clinical and physiological characteristics between males and females with MA-PAH.PopulationThe analysis included 1830 patients enrolled in the PAH biobank, with a diagnosis of MA-PAH (n=42), IPAH (n=1073), or CTD-PAH (n=715).Main outcome measuresThe study assessed and compared the clinical and haemodynamic parameters of patients with MA-PAH, IPAH and CTD-PAH.ResultsAmong the patients analysed, 42 had MA-PAH, with 69.1% being female. There were no statistically significant differences in functional class among patients with MA-PAH, IPAH and CTD-PAH. The per cent predicted 6-min walk distance (6MWD) was comparable between the three groups. Patients with MA-PAH had similar mean pulmonary artery pressure and pulmonary vascular resistance to patients with IPAH but higher compared with patients with CTD-PAH. Male patients with MA-PAH exhibited a worse functional class and lower per cent predicted 6MWD, but no significant differences in haemodynamic findings were observed between the sexes.ConclusionThere were no differences in haemodynamic between MA-PAH and IPAH but we found that MA-PAH differed from CTD-PAH. The study did not find evidence of sex differences in MA-PAH. Further research is necessary to identify risk factors and underlying mechanisms of MA-PAH, particularly considering the increasing prevalence of methamphetamine use. Such investigations will contribute to the development of effective prevention and treatment strategies for this condition.