Clinical outcomes of opioid administration in acute and chronic heart failure: A meta-analysis

Nando Reza Pratama, - and Elsha Stephanie Anastasia, - and NABILA PUTRI WARDHANI, - and David Setyo Budi, - and Ifan Ali Wafa, - and Hendri Susilo, - and Mochamad Yusuf Alsagaff, - and Citrawati Dyah Kencono Wungu, - and Henry Sutanto, - and Delvac Oceandy, - (2022) Clinical outcomes of opioid administration in acute and chronic heart failure: A meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16. ISSN 1871-4021

[img] Text (Artikel)
16. Clinical outcomes of opioid administration in acute and chronic heart failure A meta-analysis_DMSCRR 2022.pdf

Download (505kB)
[img] Text (Peer Review)
karil 16.pdf

Download (98kB)
[img] Text (Similariti)
16. Turnitin.pdf

Download (3MB)
Official URL: https://www.sciencedirect.com/science/article/pii/...

Abstract

Background and aims Opioid use in heart failure (HF) management is controversial, and whether rapid symptomatic relief outweighs the risks of opioid use in HF remains unknown. This study aimed to explore the clinical outcomes of opioid administration in patients with acute or chronic HF. Methods A systematic search for eligible studies was conducted in databases (MEDLINE, Scopus, Web of Science, EBSCO) and registries (ClinicalTrials.gov, WHO Clinical Trial Registry) until June 8, 2022. Odds ratios (ORs) or adjusted OR (aORs) and mean difference (MD) or standardized MD were quantified for binary and continuous outcomes, respectively. Meta-regression was performed using the restricted maximum likelihood method. Results A total of 20 studies (154,736 participants) were included. In acute HF, opioid use presented a high risk for in-hospital mortality (OR = 2.35; 95% confidence interval (CI): 1.03–5.38; I2 = 97%), invasive (OR = 2.78; 95%CI: 1.17–6.61; I2 = 93%) and noninvasive (OR = 2.97; 95%CI: 1.06–8.28; I2 = 95%) ventilations, intensive care unit admission (OR = 3.62; 95%CI: 3.11–4.21; I2 = 6%), and inotrope use (OR = 2.54; 95%CI: 1.94–3.32; I2 = 63%). In chronic HF New York Heart Association (NYHA) Class II/III, opioid use improved ventilatory efficiency (MD = −3.16; 95%CI: (−4.78)–(−1.54); I2 = 0%), and exercise test duration (MD = 69.24; 95%CI: 10.11–128.37; I2 = 89%). Conclusions Opioids are not recommended for acute HF management; however, they showed an advantage in exercise testing by improving ventilatory efficiency, chemosensitivity, and exercise test duration in stable patients with chronic HF NYHA Class II/III. Nonetheless, larger randomized controlled trials and individual patient-level data meta-analyses are warranted.

Item Type: Article
Uncontrolled Keywords: Cardiovascular diseaseHeart failureOpioidMorphineMeta-analysis
Subjects: R Medicine > R Medicine (General) > R5-920 Medicine (General)
Divisions: 01. Fakultas Kedokteran > Ilmu Penyakit Jantung
Creators:
CreatorsNIM
Nando Reza Pratama, -NIM011611133101
Elsha Stephanie Anastasia, -NIM011611133104
NABILA PUTRI WARDHANI, -NIM011611133105
David Setyo Budi, -UNSPECIFIED
Ifan Ali Wafa, -UNSPECIFIED
Hendri Susilo, -NIM 011528136304
Mochamad Yusuf Alsagaff, -NIDN 0014057907
Citrawati Dyah Kencono Wungu, -NIDN0022128803
Henry Sutanto, -UNSPECIFIED
Delvac Oceandy, -UNSPECIFIED
Depositing User: arys fk
Date Deposited: 04 May 2023 07:20
Last Modified: 04 May 2023 07:20
URI: http://repository.unair.ac.id/id/eprint/126122
Sosial Share:

Actions (login required)

View Item View Item