|
Geregistreerd op: 21 Jul 2019
Berichten: 195
|
Carvedilol safe for patients with HF, cocaine use disorder
Researchers have determined that carvedilol is a safe treatment option in patients with HF who have a cocaine use disorder. Further, treatment may be effective for those with reduced ejection fraction.wisepoqder Carvedilol powder
According to a study published in JACC: Heart Failure, treatment with the beta-blocker carvedilol was associated with a similar incidence of major CV events in a cohort of patients with cocaine use disorder hospitalized with HF compared with those not prescribed carvedilol (32% vs. 38%, respectively; P = .16), as well as in those with HFpEF (30% vs. 33%, respectively; P = .4 .
However, the incidence of major CV events was lower in patients with a cocaine use disorder and HFrEF who were prescribed carvedilol compared with those not prescribed carvedilol (34% vs. 58%; P = .02).
The study evaluated 503 patients with a cocaine use disorder from a cohort of 2,578 patients hospitalized with HF in 2011. Of those, 80% were prescribed carvedilol. The mean age was 60 years, 40% were black, 52% were women and 37% had diabetes.
“Our study aim was to find out if it is safe to prescribe carvedilol among patients with heart failure and cocaine use disorder,” Raza Alvi, MD, fellow in the department of cardiology at Massachusetts General Hospital, told Cardiology Today. “Our data suggested that prescribing carvedilol to individuals with heart failure with a cocaine use disorder did not result in worse outcomes compared to those not on carvedilol and in fact was associated with a lower rate of adverse cardiovascular events among those with a reduced left ventricular function/ejection fraction.”
Additionally, in a multivariate model, researchers found that carvedilol for HF was more effective for lowering the incidence of major CV events in patients with a cocaine use disorder (HR = 0.67; 95% CI, 0.481-0.863).
“This is a very important study because cocaine is one of the most commonly abused drugs in the United States and can result in a variety of cardiovascular sequela such as heart failure,” Alvi said. “Beta-blockers are the mainstay treatment of heart failure, especially with reduced ejection fraction. However, the data on safety of the use of nonselective beta-blockers such as carvedilol among patients with cocaine use disorder is scant.”
In this single-center, retrospective study of patients with a cocaine use disorder hospitalized with HF, individuals were identified based on positive urine toxicology or self-reported cocaine use. Researchers then divided the cohort by carvedilol prescription and stratified individuals by ejection fraction ( 40%, 41% to 49% or 50%). Primary outcome was major CV events, defined as CV mortality and 30-day HF readmission. |
|
|
