Cardiovascular complications among individuals with amphetamine-positive urine drug screening admitted to a tertiary care hospital in Riyadh

BACKGROUND: Amphetamine-type stimulants (ATS) are the most commonly used illicit drugs in Saudi Arabia. Frequency and outcome of ATS-related cardiovascular (CV) complications in the Saudi community have not been previously studied. AIM: We aimed to determine the incidence and the clinical outcomes of CV complications among individuals with amphetamine-positive urine drug screening (APUDS) tests admitted to a tertiary care facility in Riyadh, Saudi Arabia. METHODS: Retrospective review of consecutive cases with APUDS and concurrently positive cardiac biomarkers admitted to King Abdul-Aziz Medical City in Riyadh, Saudi Arabia, between January 2006 and December 2013. The laboratory database was queried to identify patients with positive APUDS and abnormal cardiac biomarkers. Clinical data were extracted from the electronic medical records. RESULTS: A total of 7450 urine drug screening tests were performed during the study period, out of which 720 (9.6%) were positive for ATS (APUDS group). Forty-two cases in the APUDS group were documented to have CV complications. All cases were men with a median age of 39 years (range, 21–60 years). Acute coronary syndrome/myocardial infarction was the most frequent clinical presentation (n = 31, 74%), predominantly in the form of ST-elevation myocardial infarction. Other less frequent complications included myopericarditis, cardiomyopathy, and arrhythmia. Coronary procedures were performed in 30 cases. Median hospital stay was 5 days (range, 1–28 days) and in-hospital mortality was 7.2%. CONCLUSION: APUDS is frequently encountered in young Saudi men presenting to the emergency department of our institution. Individuals with APUDS are at increased risk of CV complications and in-hospital mortality. The most frequent APUDS-related CV complication is acute coronary syndrome.