Clinical outcomes of Β-blocker therapy in cocaine-associated heart failure

Beta Blocker Therapy in Heart Failure Patients with Active Cocaine Use: A Systematic Review

“…e use of cocaine was confirmed by self-reported history and positive urine toxicology in six studies [10,12,16,18,20,21], positive urine toxicology in another five [11,13,15,17,19], and only self-reported in one study [14]. Carvedilol (combined beta1,2 and alpha blocker) alone was used in five studies [11,12,14,15,21], carvedilol, labetalol (combined beta1,2 and alpha blocker), bisoprolol, metoprolol tartrate, and metoprolol succinate were used in one study [16], and carvedilol and metoprolol succinate were used in two studies [18,20]. Both cardioselective and noncardioselective beta blockers (not specified) were used in one study [13], and three studies did not specify the type of beta blockers used [10,17,19].…”

“…Of the 12 articles reviewed, ten were retrospective studies involving a review of medical records [10,11,13,[15][16][17][18][19][20][21], one study was a case series of four patients [12], and one was a case report [14]. e sample size ranged from 1 to 503 patients with a median of 111. e total number of patients was 1994.…”

“…Both cardioselective and noncardioselective beta blockers (not specified) were used in one study [13], and three studies did not specify the type of beta blockers used [10,17,19]. e primary outcomes were readmission (all cause and heart failure related) in nine studies [10-13, 15-17, 19, 20], mortality in seven studies [10,11,13,[15][16][17]19], LVEF improvement in six studies [12-14, 17, 18, 20], NYHA functional class in three studies [12,18,20], and major adverse cardiovascular events (MACEs) in four studies [16,18,20,21] as shown in Table 2.…”

“…Nine studies provided either partial or complete data on statistical measures [10,13,[15][16][17][18][19][20][21], and one study did not report any statistical outcomes [11]. Statistical analysis was not applicable for two studies (case series and case report) [12,14].…”

“…Statistical analysis was not applicable for two studies (case series and case report) [12,14]. e risk of bias within the studies was calculated using multivariate analysis in four studies [16,[19][20][21]. Due to the retrospective nature of studies, variance in analytic approaches, and incomplete statistical data (also because of only abstract publication), formal synthesis was not possible and risk of bias across studies could not be determined.…”