PMID- 36240686
OWN - NLM
STAT- MEDLINE
DCOM- 20221026
LR  - 20221026
IS  - 1878-0334 (Electronic)
IS  - 1871-4021 (Linking)
VI  - 16
IP  - 10
DP  - 2022 Oct
TI  - Clinical outcomes of opioid administration in acute and chronic heart failure: A 
      meta-analysis.
PG  - 102636
LID - S1871-4021(22)00250-8 [pii]
LID - 10.1016/j.dsx.2022.102636 [doi]
AB  - BACKGROUND AND AIMS: Opioid use in heart failure (HF) management is 
      controversial, and whether rapid symptomatic relief outweighs the risks of opioid 
      use in HF remains unknown. This study aimed to explore the clinical outcomes of 
      opioid administration in patients with acute or chronic HF. METHODS: A systematic 
      search for eligible studies was conducted in databases (MEDLINE, Scopus, Web of 
      Science, EBSCO) and registries (ClinicalTrials.gov, WHO Clinical Trial Registry) 
      until June 8, 2022. Odds ratios (ORs) or adjusted OR (aORs) and mean difference 
      (MD) or standardized MD were quantified for binary and continuous outcomes, 
      respectively. Meta-regression was performed using the restricted maximum 
      likelihood method. RESULTS: A total of 20 studies (154,736 participants) were 
      included. In acute HF, opioid use presented a high risk for in-hospital mortality 
      (OR = 2.35; 95% confidence interval (CI): 1.03-5.38; I(2) = 97%), invasive 
      (OR = 2.78; 95%CI: 1.17-6.61; I(2) = 93%) and noninvasive (OR = 2.97; 95%CI: 
      1.06-8.28; I(2) = 95%) ventilations, intensive care unit admission (OR = 3.62; 
      95%CI: 3.11-4.21; I(2) = 6%), and inotrope use (OR = 2.54; 95%CI: 1.94-3.32; 
      I(2) = 63%). In chronic HF New York Heart Association (NYHA) Class II/III, opioid 
      use improved ventilatory efficiency (MD = -3.16; 95%CI: (-4.78)-(-1.54); 
      I(2) = 0%), and exercise test duration (MD = 69.24; 95%CI: 10.11-128.37; 
      I(2) = 89%). CONCLUSIONS: Opioids are not recommended for acute HF management; 
      however, they showed an advantage in exercise testing by improving ventilatory 
      efficiency, chemosensitivity, and exercise test duration in stable patients with 
      chronic HF NYHA Class II/III. Nonetheless, larger randomized controlled trials 
      and individual patient-level data meta-analyses are warranted.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Pratama, Nando Reza
AU  - Pratama NR
AD  - Faculty of Medicine, Universitas Airlangga, Indonesia.
FAU - Anastasia, Elsha Stephanie
AU  - Anastasia ES
AD  - Faculty of Medicine, Universitas Airlangga, Indonesia.
FAU - Wardhani, Nabila Putri
AU  - Wardhani NP
AD  - Faculty of Medicine, Universitas Airlangga, Indonesia.
FAU - Budi, David Setyo
AU  - Budi DS
AD  - Faculty of Medicine, Universitas Airlangga, Indonesia.
FAU - Wafa, Ifan Ali
AU  - Wafa IA
AD  - Faculty of Medicine, Universitas Airlangga, Indonesia.
FAU - Susilo, Hendri
AU  - Susilo H
AD  - Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, 
      Surabaya, Indonesia. Electronic address: hendrisusilo@staf.unair.ac.id.
FAU - Alsagaff, Mochamad Yusuf
AU  - Alsagaff MY
AD  - Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, 
      Surabaya, Indonesia.
FAU - Wungu, Citrawati Dyah Kencono
AU  - Wungu CDK
AD  - Department of Physiology and Medical Biochemistry, Faculty of Medicine, 
      Universitas Airlangga, Indonesia; Institute of Tropical Disease, Universitas 
      Airlangga, Indonesia. Electronic address: citrawati.dyah@fk.unair.ac.id.
FAU - Sutanto, Henry
AU  - Sutanto H
AD  - Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht 
      University, Netherlands.
FAU - Oceandy, Delvac
AU  - Oceandy D
AD  - Division of Cardiovascular Science, The University of Manchester, Manchester 
      Academic Health Science Centre, Manchester, United Kingdom; Department of 
      Biomedicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221002
PL  - Netherlands
TA  - Diabetes Metab Syndr
JT  - Diabetes & metabolic syndrome
JID - 101462250
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Humans
MH  - *Analgesics, Opioid/therapeutic use
MH  - Chronic Disease
MH  - *Heart Failure/drug therapy
MH  - Hospitalization
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Heart failure
OT  - Meta-analysis
OT  - Morphine
OT  - Opioid
COIS- Declaration of competing interest The authors report no relationships that could 
      be construed as a conflict of interest.
EDAT- 2022/10/15 06:00
MHDA- 2022/10/26 06:00
CRDT- 2022/10/14 18:26
PHST- 2022/07/06 00:00 [received]
PHST- 2022/09/17 00:00 [revised]
PHST- 2022/09/26 00:00 [accepted]
PHST- 2022/10/15 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/10/14 18:26 [entrez]
AID - S1871-4021(22)00250-8 [pii]
AID - 10.1016/j.dsx.2022.102636 [doi]
PST - ppublish
SO  - Diabetes Metab Syndr. 2022 Oct;16(10):102636. doi: 10.1016/j.dsx.2022.102636. 
      Epub 2022 Oct 2.