In-Hospital and Long-Term Outcomes of Beta-Blocker Treatment in Cocaine Users: A Systematic Review and Meta-analysis
| Autor: | Kullatham Kongpakpaisarn, Doosup Shin, Eun Sun Lee, Chandrashekar Bohra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry 030204 cardiovascular system & hematology Cochrane Library medicine.disease Chest pain Confidence interval 03 medical and health sciences 0302 clinical medicine Beta-Blocker Cocaine Meta-analysis Relative risk Internal medicine medicine Cardiology Cocaine intoxication Observational study Original Article 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine Adverse effect business |
| Zdroj: | Cardiology Research |
| ISSN: | 1923-2837 1923-2829 |
| Popis: | Background: Although beta-blocker treatment is generally contraindicated in patients presenting with acute cocaine intoxication due to concern for unopposed alpha-receptor stimulation, some studies have reported that beta-blocker treatment did not increase adverse events in these patients. As this treatment is still controversial, we performed a meta-analysis of observational studies on this topic. Methods: By searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to June 11, 2018, we identified eight observational studies with 2,048 patients who presented to hospital with cocaine-associated chest pain or after recent cocaine use. Outcomes of interest were myocardial necrosis or infarction (MI) and death during hospital stay or follow-up. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated by using a random-effects meta-analysis based on the DerSimonian-Laird method. Results: Among patients presenting with cocaine-associated chest pain or recent cocaine use, there was no significant difference in in-hospital all-cause mortality (RR, 0.59; 95% CI, 0.24 - 1.47) and MI (RR, 1.24; 95% CI, 0.74 - 2.06) between patients who did and did not receive beta-blocker treatment during their hospital stay. During long-term follow-up (mean 2.6 years), there was no significant difference in all-cause mortality (RR, 0.79; 95% CI, 0.44 - 1.41) and MI (RR, 0.96; 95% CI, 0.40 - 2.33) between the two groups. Conclusions: These results suggest that beta-blocker treatment in patients presenting with cocaine intoxication may not be as harmful as originally believed. Further clinical studies are needed to investigate this topic. Cardiol Res. 2019;10(1):40-47 doi: https://doi.org/10.14740/cr831 |
| Databáze: | OpenAIRE |
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