Clinical outcomes of Β-blocker therapy in cocaine-associated heart failure.
Adrenergic beta-Antagonists
/ pharmacology
Adult
Cocaine
/ adverse effects
Cocaine-Related Disorders
/ diagnosis
Cohort Studies
Exercise Tolerance
/ drug effects
Female
Heart Failure
/ chemically induced
Humans
Male
Middle Aged
Retrospective Studies
Stroke Volume
/ drug effects
Treatment Outcome
Vasoconstrictor Agents
/ adverse effects
Adrenergic beta-antagonists
Cocaine
Cocaine-related disorders
Heart failure
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 Feb 2019
15 Feb 2019
Historique:
received:
19
04
2018
revised:
10
07
2018
accepted:
17
08
2018
pubmed:
28
8
2018
medline:
4
9
2019
entrez:
28
8
2018
Statut:
ppublish
Résumé
Cocaine is associated with deleterious effects in the heart, including HFrEF. Although β-blockers are recommended for this condition in other populations, their use is discouraged in cocaine users due to the possibility of exacerbating cocaine-related cardiovascular complications. This study was designed to determine if patients with heart failure and a reduced ejection fraction (HFrEF) who continue to use cocaine have better outcomes when they receive β-blocker therapy than when they do not. We performed a retrospective analysis of 72 β-blocker-naïve patients with HFrEF and active cocaine use. Patients who were prescribed β-blockers as part of their therapy were compared to those who were not, and clinical and structural outcomes were compared after 12 months of treatment. When patients with HFrEF and active cocaine use received β-blocker therapy, they were more likely to have an improvement in their New York Heart Association functional class (p = 0.0106) and left ventricular ejection fraction (p = 0.0031) than when they did not receive β-antagonists. In addition, the risk of cocaine-related cardiovascular events (p = 0.0086) and of heart failure hospitalizations (p = 0.0383) was significantly lower in patients who received β-blockade than those who did not. β-Blocker therapy is associated with improvement in the exercise tolerance and the left ventricular ejection fraction in patients with HFrEF and active cocaine use. They are also associated with a lower incidence of cocaine-related cardiovascular events and HFrEF-related readmissions.
Sections du résumé
BACKGROUND
BACKGROUND
Cocaine is associated with deleterious effects in the heart, including HFrEF. Although β-blockers are recommended for this condition in other populations, their use is discouraged in cocaine users due to the possibility of exacerbating cocaine-related cardiovascular complications. This study was designed to determine if patients with heart failure and a reduced ejection fraction (HFrEF) who continue to use cocaine have better outcomes when they receive β-blocker therapy than when they do not.
METHODS
METHODS
We performed a retrospective analysis of 72 β-blocker-naïve patients with HFrEF and active cocaine use. Patients who were prescribed β-blockers as part of their therapy were compared to those who were not, and clinical and structural outcomes were compared after 12 months of treatment.
RESULTS
RESULTS
When patients with HFrEF and active cocaine use received β-blocker therapy, they were more likely to have an improvement in their New York Heart Association functional class (p = 0.0106) and left ventricular ejection fraction (p = 0.0031) than when they did not receive β-antagonists. In addition, the risk of cocaine-related cardiovascular events (p = 0.0086) and of heart failure hospitalizations (p = 0.0383) was significantly lower in patients who received β-blockade than those who did not.
CONCLUSIONS
CONCLUSIONS
β-Blocker therapy is associated with improvement in the exercise tolerance and the left ventricular ejection fraction in patients with HFrEF and active cocaine use. They are also associated with a lower incidence of cocaine-related cardiovascular events and HFrEF-related readmissions.
Identifiants
pubmed: 30146248
pii: S0167-5273(18)32508-7
doi: 10.1016/j.ijcard.2018.08.058
pii:
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Vasoconstrictor Agents
0
Cocaine
I5Y540LHVR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
153-158Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.