This study compared clinical characteristics and in-hospital and post-discharge outcomes of 62 consecutive patients (8 females; median age 41 years) with methamphetamineassociated cardiomyopathy (MAC) at Middlemore Hospital from 2006 to 2018 and compared them to an age-range matched cohort with non-ischaemic cardiomyopathy (NCM). The majority of MAC patients were of indigenous Māori ethnicity. MAC patients were younger than the NCM cohort, had higher peak N-terminal pro-B-type natriuretic peptide and lower left ventricular ejection fraction at presentation, and a higher incidence of cardiogenic shock at presentation (10 vs 2, p = 0.030). During follow-up, 15 deaths occurred in the MAC cohort compared with 7 deaths in the NCM cohort. Compared with NCM patients, MAC patients had an increased mortality risk (HR 2.7; 95% CI 1.1-6.2, p = 0.029) and a trend to more heart failure re-admissions (HR 1.6; 95% CI 1.0-2.8, p = 0.075). Independent predictors of mortality during follow-up were baseline left ventricular end diastolic diameter and failure of improvement in right ventricular systolic function, while heart failure readmission in MAC patients was predicted by failure of improvement in left ventricular ejection fraction.
