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Cheng T, Xie Z, Wang T, Jiang Y, Guo X, Liu X, Wen Y, Yang H, Wu Y. Ultrasensitive SERS Detection of Five β-Blockers Achieved Using Chemometrics with a Two-Dimensional Substrate Formed by Large-Sized Ag@SiO 2 Nanoparticles. Anal Chem 2024. [PMID: 39360675 DOI: 10.1021/acs.analchem.4c03793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
We report on a surface-enhanced Raman scattering (SERS) platform for the detection of five beta-blockers (β-blockers): atenolol, esmolol, labetalol, sotalol, and propranolol. Key to this platform was a two-dimensional substrate formed by self-assembling large Ag@SiO2 nanoparticles (Ag@SiO2 NPs) on a silicon wafer. The close arrangement of these large nanoparticles on the surface generated a strong and uniform electromagnetic field, which enhanced SERS signal intensity for the detection of small amounts of the target molecules. The intensities of characteristic peaks of the five β-blocker drugs increased linearly with the increase of their concentrations in the range of 10-5 to 10-8 mol/L. The detection limits were 10-10 mol/L for propranolol, 10-9 mol/L for atenolol, labetalol, and sotalol, and 10-8 mol/L for esmolol. Determination of these five β-blocker drugs added to human urine samples, using a portable Raman spectroscopy instrument, showed quantitative recovery (93-101%). Principal component analysis (PCA) and hierarchical cluster analysis (HCA) of SERS spectral data improved the differentiation among these five β-blockers. This study highlights the potential of the developed SERS platform for rapid, on-site detection of illicit drugs and for antidoping screening.
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Affiliation(s)
- Tao Cheng
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Ziyue Xie
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Tianrun Wang
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Yuning Jiang
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Xiaoyu Guo
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Xinling Liu
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Ying Wen
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Haifeng Yang
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
| | - Yiping Wu
- The Education Ministry Key Laboratory of Resource Chemistry, Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Key Laboratory of Rare Earth Functional Materials, and Shanghai Frontiers Science Center of Biomimetic Catalysis, College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200234, China
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Coffin PO, Suen LW. Methamphetamine Toxicities and Clinical Management. NEJM EVIDENCE 2023; 2:EVIDra2300160. [PMID: 38320504 PMCID: PMC11458184 DOI: 10.1056/evidra2300160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Methamphetamine Toxicities and Clinical ManagementMethamphetamine increases the release and blocks the uptake of norepinephrine, serotonin, and dopamine. This article reviews the morbidity and mortality associated with methamphetamine use and discusses prevention and treatment strategies.
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Affiliation(s)
- Phillip O. Coffin
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, USA
- Department of Medicine, University of California San Francisco, San Francisco CA, USA
| | - Leslie W. Suen
- Department of Medicine, University of California San Francisco, San Francisco CA, USA
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Beleño Acosta B, Advincula RC, Grande-Tovar CD. Chitosan-Based Scaffolds for the Treatment of Myocardial Infarction: A Systematic Review. Molecules 2023; 28:1920. [PMID: 36838907 PMCID: PMC9962426 DOI: 10.3390/molecules28041920] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Cardiovascular diseases (CVD), such as myocardial infarction (MI), constitute one of the world's leading causes of annual deaths. This cardiomyopathy generates a tissue scar with poor anatomical properties and cell necrosis that can lead to heart failure. Necrotic tissue repair is required through pharmaceutical or surgical treatments to avoid such loss, which has associated adverse collateral effects. However, to recover the infarcted myocardial tissue, biopolymer-based scaffolds are used as safer alternative treatments with fewer side effects due to their biocompatibility, chemical adaptability and biodegradability. For this reason, a systematic review of the literature from the last five years on the production and application of chitosan scaffolds for the reconstructive engineering of myocardial tissue was carried out. Seventy-five records were included for review using the "preferred reporting items for systematic reviews and meta-analyses" data collection strategy. It was observed that the chitosan scaffolds have a remarkable capacity for restoring the essential functions of the heart through the mimicry of its physiological environment and with a controlled porosity that allows for the exchange of nutrients, the improvement of the electrical conductivity and the stimulation of cell differentiation of the stem cells. In addition, the chitosan scaffolds can significantly improve angiogenesis in the infarcted tissue by stimulating the production of the glycoprotein receptors of the vascular endothelial growth factor (VEGF) family. Therefore, the possible mechanisms of action of the chitosan scaffolds on cardiomyocytes and stem cells were analyzed. For all the advantages observed, it is considered that the treatment of MI with the chitosan scaffolds is promising, showing multiple advantages within the regenerative therapies of CVD.
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Affiliation(s)
- Bryan Beleño Acosta
- Grupo de Investigación de Fotoquímica y Fotobiología, Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia
| | - Rigoberto C. Advincula
- Department of Chemical and Biomolecular Engineering, University of Tennessee, Knoxville, TN 37996, USA
- Center for Nanophase Materials Sciences (CNMS), Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - Carlos David Grande-Tovar
- Grupo de Investigación de Fotoquímica y Fotobiología, Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia
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Muacevic A, Adler JR, Mangal RK, Lopez Ortiz C, Ganti L. Non-ST Segment Elevation Myocardial Infarction Associated With Cocaine Use. Cureus 2022; 14:e32875. [PMID: 36694533 PMCID: PMC9867892 DOI: 10.7759/cureus.32875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
We present the case of a 23-year-old male with no significant past medical history who experienced acute chest pain. A diagnostic workup revealed that the patient had a non-ST-segment elevation myocardial infarction. Although the patient was not forthcoming initially with his cocaine use, he did admit it later in his emergency department course. The timing of his rise and fall of troponin is presented. The pathophysiology of cocaine-related chest pain and infarction is discussed. The patient continued to make an uneventful recovery.
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Abstract
Sympathomimetic drugs comprise a broad category of substances including both illicit and prescribed drugs that have deleterious effects when ingested or abused. The clinical syndromes that result from overstimulation of the sympathetic nervous system by reuptake inhibition of biogenic amines, such as norepinephrine and dopamine, carry significant morbidity. Recognition and awareness of the appropriate supportive measures are required to mitigate life-threatening complications of multiple organ systems. The sympathomimetic toxidrome is recognized by a constellation of symptoms including agitation, hyperthermia, tachycardia, and hypertension, and the primary treatment involves supportive care, including the liberal use of benzodiazepines.
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Affiliation(s)
- Hallie Brown
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA
| | - Katherine A Pollard
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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Elkattawy S, Alyacoub R, Al-Nassarei A, Younes I, Ayad S, Habib M. Cocaine induced heart failure: report and literature review. J Community Hosp Intern Med Perspect 2021; 11:547-550. [PMID: 34211666 PMCID: PMC8221130 DOI: 10.1080/20009666.2021.1926614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Heart failure is a complex clinical syndrome associated with high mortality and morbidity, creating a major public healthcare problem. It has a variety of etiologies, including substance abuse. Cocaine-induced cardiotoxicity is caused by direct effects of inhibition of sodium channels and indirect effects by inhibiting catecholamine uptake leading to increased sympathetic activity. Management is through the cessation of cocaine use and implantation of guideline-directed medical therapy for heart failure with the exception of beta-blockers as their safe usage is still controversial due to the risk of the unopposed alpha-adrenergic activity. Dexmedetomidine (Precedex) and Benzodiazepines (i.e., midazolam) are options for patients that demonstrate signs and symptoms of acute cocaine intoxication. If the actions of benzodiazepines fail to achieve hemodynamic stability, nitroglycerin may be used (especially in patients with cocaine-associated chest pain and hypertension). Cardiac transplantation is recommended for those who have demonstrated severe cardiovascular disease from cocaine. We present a 43-year-old male with a long-standing history of cocaine use who developed cardiomyopathy and severe acute decompensated heart failure found to have an ejection fraction of <20% admitted to the intensive care unit. He required inotropic support with milrinone and mechanical ventilation. He was later extubated and then discharged with an outpatient evaluation for a cardiac transplant.
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Affiliation(s)
- Sherif Elkattawy
- Department of Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center Program, Elizabeth, NJ, USA
| | - Ramez Alyacoub
- Department of Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center Program, Elizabeth, NJ, USA
| | - Abraham Al-Nassarei
- Internal Medicine, St George's University School of Medicine, Grenada, West Indies
| | - Islam Younes
- Department of Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center Program, Elizabeth, NJ, USA
| | - Sarah Ayad
- Department of Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center Program, Elizabeth, NJ, USA
| | - Mirette Habib
- Department of Internal Medicine, Division of Cardiology, Trinitas Regional Medical Center, Elizabeth, NJ, USA
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Zhang JG, Dai SP, Liu H, Xu ZS. Comparison of carvedilol versus metoprolol in patients with acute myocardial infarction: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25855. [PMID: 34011052 PMCID: PMC8137039 DOI: 10.1097/md.0000000000025855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The existing meta-analyses and randomized studies on comparing the effects of carvedilol and metoprolol are of poor quality, with small sample sizes, and involve a homogeneous population. Therefore, to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to compare the mortality benefits of carvedilol with metoprolol head to head and determine the better beta-blocker in acute myocardial infarction (AMI) setting. METHODS Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in May 2021 by 2 independent reviewers. The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. The primary outcome is all-cause mortality; secondary outcomes include complex cardiovascular events, sudden death, cardiovascular death, reinfarction, revascularization, readmission, ventricular arrhythmias, and drug withdrawal for all causes except death. All outcomes are pooled on random-effect model. A P value of <.05 is considered to be statistically significant. RESULTS The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER 10.17605/OSF.IO/VSTJC.
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Di Fusco SA, Rossini R, Flori M, Pollarolo L, Ingianni N, Malvezzi Caracciolo D'Aquino M, Galati G, Zilio F, Iorio A, Scotto di Uccio F, Lucà F, Gulizia MM, Ciccirillo F, Gabrielli D, Colivicchi F. Pathophysiology and management of recreational drug-related acute coronary syndrome: ANMCO position statement. J Cardiovasc Med (Hagerstown) 2021; 22:79-89. [PMID: 32858637 DOI: 10.2459/jcm.0000000000001091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recreational drug use may cause coronary artery disease through several mechanisms. An increasing number of young patients with drug-related acute coronary syndrome have been reported over recent years. The present position statement reports the most recent epidemiological data on acute coronary syndrome in the setting of drug abuse, describes the main pathophysiological mechanisms underlying coronary artery disease and acute events in these patients, and provides practical recommendations on management and an overview of prognosis.
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Affiliation(s)
| | - Roberta Rossini
- U.O.C. Cardiologia, Azienda Ospedaliera Santa Croce e Carle, Cuneo
| | - Marco Flori
- U.O.C. Cardiologia, Presidio Ospedaliero Unico Urbino (PU)
| | - Luigi Pollarolo
- U.O.C Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Nadia Ingianni
- U.O.C. Cardiologia, Presidio Ospedaliero Paolo Borsellino, Marsala (TP)
| | | | - Giuseppe Galati
- Divisione di Cardiologia, IRCCS Ospedale San Raffaele, Milan
| | | | - Annamaria Iorio
- U.S.C. Cardiologia 2, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo
| | | | - Fabiana Lucà
- U.O.C. Cardiologia, A.O. Bianchi Melacrino Morelli, Reggio Calabria
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione 'Garibaldi', Catania
- Presidente Fondazione per il Tuo cuore, Firenze - Heart Care Foundation Onlus, Florence
| | | | - Domenico Gabrielli
- U.O.C Cardiologia, Ospedale Civile Augusto Murri, Area Vasta 4 Fermo, ASUR Marche, Fermo (AN), Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, P.O San Filippo Neri - ASL Roma1, Rome
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Gresnigt FM, Gubbels NP, Riezebos RK. The current practice for cocaine-associated chest pain in the Netherlands. Toxicol Rep 2020; 8:23-27. [PMID: 33384944 PMCID: PMC7770504 DOI: 10.1016/j.toxrep.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Cocaine is considered a cardiovascular risk factor, yet it is not included in the frequently used risk stratification scores. Moreover, many guidelines provide limited advice on how to diagnose and treat cocaine-associated chest pain (CACP). This study aimed to determine the current practice for CACP patients in emergency departments and coronary care units throughout the Netherlands. METHODS An anonymous online questionnaire-based survey was conducted among Dutch emergency physicians and cardiologists between July 2015 and February 2016. The questionnaire was based on the American Heart Association CACP treatment algorithm. RESULTS A total of 214 subjects were enrolled and completed the questionnaire. All responders considered cocaine use a risk factor for developing acute coronary syndrome (ACS), nevertheless 74.4 % of emergency physicians and 81.1 % of cardiologists do not always question chest pain patients about drug use. Of all responders, 73.6 % never perform toxicology screening. Most responders (60 %) observe patients with CACP according to the European Society of Cardiology ACS guideline, and 24.3 % give these patients ß-blockers. CONCLUSION The current practice for CACP patients in most emergency departments and coronary care units in the Netherlands is not in line with the AHA scientific statement. Emergency physicians and cardiologists should be advised to routinely question all chest pain patients on drug history and be aware that the risk stratifications scores are not validated for CACP. Despite the AHA scientific statement of 2008, many respondents utilize ß-blockers for CACP patients, which is supported by published evidence since the statement appeared.
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Affiliation(s)
- Femke M.J. Gresnigt
- Emergency Physician, Emergency Department, OLVG Hospital, Oosterpark 9, 1091AC, Amsterdam, the Netherlands
| | - Nanda P. Gubbels
- Emergency Medicine Resident, Emergency Department, OLVG Hospital, Oosterpark 9, 1091AC, Amsterdam, the Netherlands
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Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, Kudenchuk PJ, Kurz MC, Lavonas EJ, Morley PT, O’Neil BJ, Peberdy MA, Rittenberger JC, Rodriguez AJ, Sawyer KN, Berg KM, Arafeh J, Benoit JL, Chase M, Fernandez A, de Paiva EF, Fischberg BL, Flores GE, Fromm P, Gazmuri R, Gibson BC, Hoadley T, Hsu CH, Issa M, Kessler A, Link MS, Magid DJ, Marrill K, Nicholson T, Ornato JP, Pacheco G, Parr M, Pawar R, Jaxton J, Perman SM, Pribble J, Robinett D, Rolston D, Sasson C, Satyapriya SV, Sharkey T, Soar J, Torman D, Von Schweinitz B, Uzendu A, Zelop CM, Magid DJ. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S366-S468. [DOI: 10.1161/cir.0000000000000916] [Citation(s) in RCA: 371] [Impact Index Per Article: 92.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Untoward side effects of pharmaceuticals can result in considerable morbidity and expense to the health care system. There is likely a sizable fraction of the hypertensive population with disease either induced or exacerbated by polypharmacy. The elevation of blood pressure in drug-induced hypertension occurs through a variety of mechanisms, most notably, sodium and fluid retention, activation of the renin-angiotensin-aldosterone system, alteration of vascular tone, or a combination of these pathways. Recognition of common medications causing drug-induced hypertension is important to effectively control blood pressure. The epidemiology, pathophysiology, and management of these agents are discussed.
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Affiliation(s)
- Matthew C Foy
- Division of Nephrology, Louisiana State University Health Science Center, 5246 Brittany Dr, Baton Rouge, LA 70808, USA
| | - Joban Vaishnav
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA
| | - Christopher John Sperati
- Division of Nephrology, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 416, Baltimore, MD 21287, USA.
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Shin D, Lee ES, Bohra C, Kongpakpaisarn K. In-Hospital and Long-Term Outcomes of Beta-Blocker Treatment in Cocaine Users: A Systematic Review and Meta-analysis. Cardiol Res 2019; 10:40-47. [PMID: 30834058 PMCID: PMC6396807 DOI: 10.14740/cr831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/08/2019] [Indexed: 11/11/2022] Open
Abstract
Background Although β-blocker treatment is generally contraindicated in patients presenting with acute cocaine intoxication due to concern for unopposed α-receptor stimulation, some studies have reported that β-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 β-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 β-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.
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Affiliation(s)
- Doosup Shin
- Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33606, USA
| | - Eun Sun Lee
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL 60640, USA
| | - Chandrashekar Bohra
- Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33606, USA
| | - Kullatham Kongpakpaisarn
- Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33606, USA
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