Improvement in clinical outcomes of patients with heart failure and active cocaine use after β‐blocker therapy. Issue 4 (17th April 2018)

• Record Type: Journal Article
• Authors: Lopez, Persio D.; Akinlonu, Adedoyin; Mene‐Afejuku, Tuoyo O.; Dumancas, Carissa; Saeed, Mohammed; Cativo, Eder H.; Visco, Ferdinand; Mushiyev, Savi; Pekler, Gerald
• Is Part Of: Clinical cardiology. Volume 41:Issue 4(2018)
• Page Start: 465
• Page End: 469
• Publication Date: 2018-04-17
• Subjects: Clinical Pharmacology -- General Clinical Cardiology/Adult -- Heart Failure; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22897
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : Background: Cocaine use has a high prevalence in the United States and can be associated with significant cardiovascular disease, even in asymptomatic users. β‐Adrenergic receptor hyperactivation is the underlying pathophysiologic pathway of cocaine cardiotoxicity. β‐Blocker therapy is controversial in patients with active cocaine use. Hypothesis: β‐Blocker therapy is associated with clinical improvement in patients with heart failure despite active cocaine use. Methods: In a single‐center, retrospective chart analysis, patients with newly diagnosed heart failure and active cocaine use who had been started on β‐blocker therapy were reviewed. The New York Heart Association (NYHA) functional class and the left ventricular ejection fraction (LVEF) were recorded at baseline and after 12 monthsnthsnths of β‐blocker use. Patients were excluded if they had been on prior β‐blocker therapy, had other reasons for volume overload, had chronic kidney disease stages G4 or G5, or had a life expectancy <12 months. Results: Thirty‐eight patients were identified; most were African American males. A statistically significant improvement was found in both NYHA functional class ( P < 0.0001) and LVEF ( P < 0.0001) after 12 months of β‐blocker therapy. No major adverse cardiovascular events occurred in this population. Conclusions: β‐Blocker use in cocaine users with heart failure with a reduced ejection fraction is associated with a lower NYHA functional class and a higher LVEF at 12‐month follow‐up. No major adverse cardiovascular events were observed.