Opioid Use in Patients with Congestive Heart Failure

Abstract

Opioid use at admission or discharge in patients with CHF did not appear to affect outcomes.

Characterization of opioid use in sickle cell disease

“…Opioid use has also been associated with adverse respiratory outcomes, 32,33 but not heart failure in other patient populations. 34,35 Both the prevalence and dose of opioids increased significantly from the 0 to 9 age group to the 10 to 19 year age group, implying that the vaso-occlusive pain increases during the second decade of life in the SCD patients. The prevalence of opioid use slowly declined with increasing age after reaching the peak at the 20 to 29 years group, especially in the age group of 50+ years old ( Table 1).…”

“…Exposure to high‐dose morphine and its active metabolite, morphine‐6‐glucuronide, has been suggested to increase the risk of ACS in SCD patients, which is consistent with our observation. Opioid use has also been associated with adverse respiratory outcomes, but not heart failure in other patient populations …”

“…Opioid use has also been associated with adverse respiratory outcomes, 32,33 but not heart failure in other patient populations. 34,35…”

Prescription opioid use before and after heart transplant: Associations with posttransplant outcomes

“…9 Pain is a common finding in end-stage heart failure, reported by 84% of patients. 12 Presurgical use of opioid analgesics is increasingly recognized as a predictor of postoperative complications and increased resource utilization in diverse populations, including patients undergoing general and orthopedic surgery, living donor nephrectomy procedures, and some forms of solid organ transplant. 11 In one cohort, nearly 25% of patients hospitalized with decompensated heart failure had an opioid prescription on admission.…”

“…11 In one cohort, nearly 25% of patients hospitalized with decompensated heart failure had an opioid prescription on admission. 12 Presurgical use of opioid analgesics is increasingly recognized as a predictor of postoperative complications and increased resource utilization in diverse populations, including patients undergoing general and orthopedic surgery, living donor nephrectomy procedures, and some forms of solid organ transplant. [13][14][15][16] Risks of opioid-related toxicity may be especially pronounced in patients with end-stage organ failure due to altered drug protein binding, metabolism, and excretion, leading to accumulation of parent agents and potentially toxic metabolites.…”