{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T04:02:30Z","timestamp":1751601750899,"version":"3.41.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Methamphetamine 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>National 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 <jats:italic>t<\/jats:italic>-test for continuous variables was used for the weighted sample. <jats:italic>P<\/jats:italic>-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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Stimulant use was more likely to be associated with HFrEF (OR\u2009=\u20091.97, CI 1.93\u20132.01), while less associated with HFpEF (OR\u2009=\u20090.96, CI 0.94\u20130.98). HF among stimulant users was common (<jats:italic>p<\/jats:italic>\u2009<jats:italic>&amp;lt;<\/jats:italic>\u20090.001) in males, those aged 41\u201364, Black patients, Medicaid users, those in the &amp;lt;50 percentile income, and the South or West regions. Stimulant-related HF hospitalizations increased significantly from 2008 to 2020 for all subcategories (<jats:italic>p<\/jats:italic>\u2009<jats:italic>&amp;lt;<\/jats:italic>\u20090.001). \u202f<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Stimulant 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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1566481","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T05:27:21Z","timestamp":1751520441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospitalized patients and stimulant use-associated heart failure: importance of ejection fraction and related risk factors"],"prefix":"10.3389","volume":"12","author":[{"given":"Akshat","family":"Agrawal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke","family":"Scardino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diensn G.","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. 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