PMID- 29663434
OWN - NLM
STAT- MEDLINE
DCOM- 20180924
LR  - 20220408
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 41
IP  - 4
DP  - 2018 Apr
TI  - Improvement in clinical outcomes of patients with heart failure and active 
      cocaine use after beta-blocker therapy.
PG  - 465-469
LID - 10.1002/clc.22897 [doi]
AB  - BACKGROUND: Cocaine use has a high prevalence in the United States and can be 
      associated with significant cardiovascular disease, even in asymptomatic users. 
      beta-Adrenergic receptor hyperactivation is the underlying pathophysiologic pathway 
      of cocaine cardiotoxicity. beta-Blocker therapy is controversial in patients with 
      active cocaine use. HYPOTHESIS: beta-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 beta-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 beta-blocker use. Patients were excluded if they had been on 
      prior beta-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 beta-blocker therapy. No major 
      adverse cardiovascular events occurred in this population. CONCLUSIONS: beta-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.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Lopez, Persio D
AU  - Lopez PD
AUID- ORCID: 0000-0002-5879-4419
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Akinlonu, Adedoyin
AU  - Akinlonu A
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Mene-Afejuku, Tuoyo O
AU  - Mene-Afejuku TO
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Dumancas, Carissa
AU  - Dumancas C
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Saeed, Mohammed
AU  - Saeed M
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Cativo, Eder H
AU  - Cativo EH
AD  - Department of Medicine, Health+Hospitals/Metropolitan, New York, New York.
FAU - Visco, Ferdinand
AU  - Visco F
AD  - Department of Medicine, Division of Cardiology, Health+Hospitals/Metropolitan, 
      New York, New York.
FAU - Mushiyev, Savi
AU  - Mushiyev S
AD  - Department of Medicine, Division of Cardiology, Health+Hospitals/Metropolitan, 
      New York, New York.
FAU - Pekler, Gerald
AU  - Pekler G
AD  - Department of Medicine, Division of Cardiology, Health+Hospitals/Metropolitan, 
      New York, New York.
LA  - eng
PT  - Journal Article
DEP - 20180417
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adrenergic beta-Antagonists/adverse effects/*therapeutic use
MH  - Clinical Decision-Making
MH  - Cocaine-Related Disorders/*complications/diagnosis/physiopathology
MH  - Female
MH  - Heart Failure/complications/diagnosis/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - New York City
MH  - Patient Selection
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/*drug effects
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*drug effects
PMC - PMC6489838
OTO - NOTNLM
OT  - Clinical Pharmacology
OT  - General Clinical Cardiology/Adult
OT  - Heart Failure
COIS- The authors declare no potential conflicts of interest.
EDAT- 2018/04/18 06:00
MHDA- 2018/09/25 06:00
PMCR- 2018/04/17
CRDT- 2018/04/18 06:00
PHST- 2017/11/08 00:00 [received]
PHST- 2018/01/05 00:00 [revised]
PHST- 2018/01/06 00:00 [accepted]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2018/09/25 06:00 [medline]
PHST- 2018/04/18 06:00 [entrez]
PHST- 2018/04/17 00:00 [pmc-release]
AID - CLC22897 [pii]
AID - 10.1002/clc.22897 [doi]
PST - ppublish
SO  - Clin Cardiol. 2018 Apr;41(4):465-469. doi: 10.1002/clc.22897. Epub 2018 Apr 17.