International journal of cardiology · 2018
Clinical outcomes of Β-blocker therapy in cocaine-associated heart failure.
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Lopez Persio D, Akinlonu Adedoyin, Mene-Afejuku Tuoyo O, Dumancas Carissa, Saeed Mohammed, Cativo Eder H, Visco Ferdinand, Mushiyev Savi, Pekler Gerald
Аннотация
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: 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: 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: 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.
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: 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: 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.