Cardiac manifestations of post-acute withdrawal syndrome from a history of synthetic cathinone and opioid use
Shukimbayeva A. Prilutskaya M. Mansurova J.
November 2024Malaysian Medical Association
Medical Journal of Malaysia
2024#79Issue 6703 - 707 pp.
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.
cardiac symptoms , opioids , post-acute withdrawal syndrome , Synthetic cathinones
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Pavlodar Branch of the Non-Commercial Joint-Stock Company Semey Medical University, Republic Scientific and Practical Centre for Mental Health, Toraigyrov St. 72/1, Pavlodar, Kazakhstan
Non-Commercial Joint-Stock Company “Semey Medical University”, Abay St. 103, Semey, Kazakhstan
Pavlodar Branch of the Non-Commercial Joint-Stock Company Semey Medical University
Non-Commercial Joint-Stock Company “Semey Medical University”
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