Alawoè Catléya, Chapet Nicolas, Roubille François, Peyrière Hélène, Eiden Céline
Addictovigilance Centre, Montpellier University Hospital, 34295 Montpellier, France.
Cardiology Department, Montpellier University Hospital, 34295 Montpellier, France.
J Clin Med. 2024 Nov 29;13(23):7275. doi: 10.3390/jcm13237275.
Cocaine use can cause multiple cardiovascular complications, including heart failure. This general review of the literature delivers data on the relationship between cocaine consumption and the development of heart failure, as well as the elements of its diagnosis and management. A literature search was carried out using the PubMed, Web Of Science, and Google Scholar bibliographic databases over the period of 2007-2022 using the following keywords: "cocaine" AND "heart failure" NOT "acute heart disease". The exclusion criteria exempted studies carried out on animals, along with articles not written in English. A total of 27 articles (11 reviews, 10 clinical studies, 4 letters to the editor, and 2 clinical cases) were included. The prevalence of heart failure among cocaine users varies from one study to another (2.5%, 5.3%, 6.2%, or even 20%); however, when patients have a history of cocaine consumption, the prevalence of heart failure is higher than that ordinarily found in the young population (<0.1% to 0.5%). Cocaine consumption has a number of serious cardiotoxic effects that can lead to heart failure. According to the studies analysed, heart failure should be treated with beta-blockers, even in the event of long-term cocaine use, with a preference for carvedilol. Despite previous concerns about the use of beta-blockers in cocaine users, treatment with beta-blockers (particularly carvedilol) may actually result in measurable clinical improvement. Cocaine withdrawal remains essential for optimal treatment.
使用可卡因会引发多种心血管并发症，包括心力衰竭。这篇文献综述提供了关于可卡因使用与心力衰竭发展之间关系的数据，以及其诊断和管理的要素。在2007年至2022年期间，使用PubMed、科学网和谷歌学术文献数据库进行了文献检索，使用的关键词如下：“可卡因”和“心力衰竭”，不包括“急性心脏病”。排除标准包括对动物进行的研究以及非英文撰写的文章。总共纳入了27篇文章（11篇综述、10篇临床研究、4封给编辑的信和2个临床病例）。可卡因使用者中心力衰竭的患病率因研究而异（2.5%、5.3%、6.2%甚至20%）；然而，当患者有可卡因使用史时，心力衰竭的患病率高于年轻人群中通常发现的患病率（<0.1%至0.5%）。使用可卡因会产生许多严重的心脏毒性作用，可导致心力衰竭。根据分析的研究，即使在长期使用可卡因的情况下，心力衰竭也应使用β受体阻滞剂治疗，首选卡维地洛。尽管此前人们对在可卡因使用者中使用β受体阻滞剂存在担忧，但使用β受体阻滞剂（尤其是卡维地洛）治疗实际上可能会带来可测量的临床改善。可卡因戒断对于最佳治疗仍然至关重要。
