{"title":"Cardiac manifestations of post-acute withdrawal syndrome from a history of synthetic cathinone and opioid use.","authors":"A Shukimbayeva, M Prilutskaya, J Mansurova","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Synthetic cathinones and opioids are among the most commonly used illicit drugs in Central Asia, including Kazakhstan. Despite the advent of synthetic cathinones, opioids have not lost their relevance. Patients frequently report poly-dependence, combining cathinones and opioids. The use of synthetic cathinones and opioids is associated with cardiovascular disease and cardiovascular mortality. However, there is limited data describing the cardiac effects of synthetic cathinones and opioids in patients with post-acute withdrawal syndrome. The aim of this work is to describe and compare the cardiac manifestations in patients using synthetic cathinones and opioids with post-acute withdrawal syndrome.</p><p><strong>Materials and methods: </strong>In this case-control study, we examined 294 patients over the age of 18 who were using synthetic cathinones and opioids. All patients underwent electrocardiography and transthoracic echocardiography.</p><p><strong>Results: </strong>Our study involved 183 patients using synthetic cathinones and 111 patients reporting opioid use. The average age of the patients was 32.4 ± 8.5 years. In patients using synthetic cathinones, electrocardiography showed a lengthening in the average duration of the ventricular QRS complex (70.5 ± 13.3 ms vs. 69.6 ± 11.7 ms), T wave (154.1 ± 27.5 ms vs. 140.4 ± 24.1 ms), and QT interval (338.2 ± 28.5 ms vs. 334.8 ± 33.5 ms), as well as a shortening of the P wave (79.1 ± 12.2 ms vs. 82.6 ± 14.4 ms) and PQ interval (146.4 ± 19.6 ms vs. 148.3 ± 20.1 ms). Echocardiography confirmed left ventricular hypertrophy in 10.9% of the synthetic cathinones group and 17.1% of the opioid group. Transmitral left ventricular diastolic dysfunction was diagnosed in 23.5% of patients in both groups. Additionally, 31.1% of patients using synthetic cathinones and 44.1% of those using opioids had a reduced ejection fraction on echocardiography.</p><p><strong>Conclusion: </strong>In patients using synthetic cathinones the QT interval was longer compared to those using opioids. The ejection fraction was lower in the opioid group. Electrocardiographic and echocardiographic screening should be conducted for all patients with post-acute withdrawal syndrome to prevent life-threatening arrhythmias and heart failure.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"703-707"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Synthetic cathinones and opioids are among the most commonly used illicit drugs in Central Asia, including Kazakhstan. Despite the advent of synthetic cathinones, opioids have not lost their relevance. Patients frequently report poly-dependence, combining cathinones and opioids. The use of synthetic cathinones and opioids is associated with cardiovascular disease and cardiovascular mortality. However, there is limited data describing the cardiac effects of synthetic cathinones and opioids in patients with post-acute withdrawal syndrome. The aim of this work is to describe and compare the cardiac manifestations in patients using synthetic cathinones and opioids with post-acute withdrawal syndrome.
Materials and methods: In this case-control study, we examined 294 patients over the age of 18 who were using synthetic cathinones and opioids. All patients underwent electrocardiography and transthoracic echocardiography.
Results: Our study involved 183 patients using synthetic cathinones and 111 patients reporting opioid use. The average age of the patients was 32.4 ± 8.5 years. In patients using synthetic cathinones, electrocardiography showed a lengthening in the average duration of the ventricular QRS complex (70.5 ± 13.3 ms vs. 69.6 ± 11.7 ms), T wave (154.1 ± 27.5 ms vs. 140.4 ± 24.1 ms), and QT interval (338.2 ± 28.5 ms vs. 334.8 ± 33.5 ms), as well as a shortening of the P wave (79.1 ± 12.2 ms vs. 82.6 ± 14.4 ms) and PQ interval (146.4 ± 19.6 ms vs. 148.3 ± 20.1 ms). Echocardiography confirmed left ventricular hypertrophy in 10.9% of the synthetic cathinones group and 17.1% of the opioid group. Transmitral left ventricular diastolic dysfunction was diagnosed in 23.5% of patients in both groups. Additionally, 31.1% of patients using synthetic cathinones and 44.1% of those using opioids had a reduced ejection fraction on echocardiography.
Conclusion: In patients using synthetic cathinones the QT interval was longer compared to those using opioids. The ejection fraction was lower in the opioid group. Electrocardiographic and echocardiographic screening should be conducted for all patients with post-acute withdrawal syndrome to prevent life-threatening arrhythmias and heart failure.
期刊介绍:
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.