Effect of β-blocker Therapy on Hospital Readmission and Mortality in Heart Failure Patients With Concurrent Cocaine Use

Abstract

The BBT reduced 30-day, all-cause and heart failure-related readmission rate but not 1-year mortality in patients having HFrEF with concurrent cocaine use.

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

“…No timeline was defined for active cocaine use in any of the studies reviewed. 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].…”

“…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.…”

“…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]. 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.…”

“…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].…”