Clinical characteristics and outcome of heart failure and captagon amphetamine use: An observational prospective study

IntroductionThe fenetylline (captagon) tablets (an amphetamine like substance) are a stimulant drugs which are widely used in the Arabian Peninsula.ObjectivesThe aim of this study was to evaluate the clinical characteristics and outcome of acute heart failure in patients using captagon tablets.MethodsFrom September, 2009, through December, 2011, 280 consecutive patients with acute dilated cardiomyopathy and acute heart failure syndrome presented to emergency department in one tertiary care center in Saudi Arabia were enrolled in this study. Patients were divided into 2 groups group I (40 patients) were captagon users and group II (240) were captagon non-users. Captagon use was elicited mainly by history taking on admission. Patients with coronary artery disease were excluded.ResultsFourteen percent of patients (40 patients) were captagon users. Captagon users were younger (mean age in years of 23±12 vs. 28±9) and almost all of them were male (98% vs. 72%). About 40 % of captagon users were alcohol users and about 92% of them were smokers. Overall, captagon users had higher risk of in-hospital death (7% vs. 4%, p value <0.05), cardiogenic shock (15% vs. 8%, p value <0.05), pulmonary tuberculosis (7% vs. 1%, p value <0.05) and recurrent admission with heart failure (35% vs. 24%, p value <0.05). After adjustment for baseline variability, captagon use was found to be an independent risk factor of death and for recurrent admission in patients presented with cardiomyopathy and acute heart failure.ConclusiosCaptagon use was found to be an independent risk factor of death and other morbidities in patients presented with cardiomyopathy and acute heart failure. Our study underscores the importance of improving education concerning the cardiac risks of captagon use