IV Narcotics Safe in Acute Coronary Syndrome Patients

Intravenous narcotics use does not adversely affect outcomes, may even be beneficial
By Monica Smith
HealthDay Reporter

THURSDAY, April 29 (HealthDay News) -- Use of intravenous narcotics (IVN) is common in different scenarios for patients with different types of acute coronary syndromes, and it does not appear to have an adverse effect on outcomes, according to research published in the April 1 issue of the American Journal of Cardiology.

Zaza Iakobishvili, M.D., of Tel Aviv University in Israel, and colleagues conducted a retrospective analysis of the 30-day outcomes stratified by IVN use of 765 patients with ST-segment elevation acute coronary syndromes (STEACS) and 993 patients with non-STEACS (NSTEACS).

The researchers found that 261 (34.1 percent) of the patients with STEACS and 97 (9.8 percent) with non-STEACS had received IVNs. Of 249 matched STEACS pairs, those who received IVNs had a lower 30-day death rate (2.4 versus 6.2 percent; P = 0.04); no difference was found in 30-day death rate among 95 matched NSTEACS pairs (2.2 percent for those who received IVNs versus 6.3 percent; P = 0.16). They also found that the STEACS patients who received IVNs were more likely to have reperfusion, underwent it more quickly, and were more likely to have coronary angiography and revascularization. NSTEACS patients who received IVNs had a higher likelihood of presenting with Killip class II to IV and of having left ventricular systolic dysfunction.

"The main finding of our study was that IVN use, per se, did not adversely affect outcomes," the authors write. "In both scenarios [patients with STEACS and patients with NSTEACS], the adjusted outcomes tended to be better among patients receiving IVN, indicating that IVN use is safe and perhaps even beneficial, if used appropriately."

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