Abstract 4366459: Amping the Arrhythmia: Hospital Burden of Cardiac Dysrhythmias in Psychostimulant Users

Background: Cardiac dysrhythmias (CDs) are serious cardiovascular complications increasingly observed in association with illicit stimulant use. Methamphetamine and cocaine are known to exert cardiotoxic effects, yet national trends and demographic disparities in CD-related hospitalizations among users remain underexplored. Objective: To assess national trends and demographic disparities in cardiac dysrhythmia hospitalizations among methamphetamine and cocaine users in the U.S. from 2008 to 2020. Methods: We used data from the National Inpatient Sample (2008–2020). We used ICD-9 (427) and ICD-10 (I46, I48, I48) codes to identify adult hospitalizations with a primary diagnosis of cardiac dysrhythmias who were also diagnosed as methamphetamine or cocaine users. National estimates were generated using sampling weights. Linear trend analysis and Cochran-Armitage trend tests assessed annual changes. Subgroup analyses were conducted by sex, race/ethnicity, age, region, and mortality status. Results: The overall number of cardiac dysrhythmia (CD) hospitalizations remained stable at ~5 million annually (p = 0.95), but significant increases were observed among males (p = 0.03), non-Hispanic Whites (p = 0.02), Hispanics (p = 0.02), and Asians (p < 0.01). In contrast, CD-related hospitalizations among methamphetamine and cocaine users rose sharply, increasing by 105% from 2008 to 2020 (p < 0.01). Male admissions increased by 122% (p < 0.01) and female admissions by 72% (p < 0.01). Asian and Hispanic populations saw the most significant increases (481% and 189%, respectively (p < 0.01)), followed by Whites (192%) (p < 0.01), African Americans 80% (p < 0.01), Native Americans 360% (p < 0.01), and other races 300% (p < 0.01). Admissions in the 26–40 age group rose 23.8% (p < 0.01), while the 41–64 and 65+ age groups increased by 110% and 230%, respectively (p < 0.01). Regionally, the West experienced the most significant rise 319% (p < 0.01), though the South consistently had the highest number of cases. The Midwest and Northeast saw increases of 93% and 32%, respectively (p < 0.01). In-hospital mortality for this group rose 283% over the study period (p < 0.01). Conclusions: Cardiac dysrhythmia hospitalizations related to methamphetamine and cocaine use have risen sharply across all major demographic groups. Despite stable overall incidence, mortality has significantly increased, highlighting a growing clinical burden and urgent need for targeted prevention strategies.