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Electrocardiographic Findings in Mortalities Due to Pure Methadone Toxicity

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Abstract

We aimed to evaluate electrocardiographic (ECG) abnormalities in mortalities due to pure methadone toxicity in ICU patients since methadone-related mortality may be due to cardiac complications even in acute toxicities. In a retrospective single-center study, files of all patients who had died with confirmed diagnosis of pure methadone toxicity between 2011 and 2016 were evaluated. Autopsy was performed in all cases. A cardiologist measured all ECG quantitative and qualitative indices. Fifty-one deaths were recorded. Forty-two dead patients were males. Median [IQR] age of the patients was 44 [30, 60] years. Of them, 38 (69%) were methadone-dependent and were significantly older than methadone-naïve patients (p = 0.008 and p = 0.001, respectively). ECG abnormalities were detected in all cases. ST-T abnormalities were found in 33 (64.7%) patients. Except longer PR interval in dependent patients (p = 0.017) and specific ST elevation in naïve cases (p = 0.008), other ECG indices were similar in two groups. No correlation was found between ST-T abnormalities and coronary disease in autopsy. ECG abnormalities irrelevant to coronary artery diseases are common in methadone-related mortalities. Methadone toxicity may affect myocardium and play a role in death. Further prospective studies to evaluate other cardiac indices in methadone-poisoned patients are recommended.

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Acknowledgements

This study was supported by Social Determinants of Health Research Center, Shahid Beheshti University of Medical sciences, Tehran, Iran and approved by our local ethics committee (IR.SBMU.RETECH.REC.1397.31).

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Authors and Affiliations

  1. Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran

    Mehdi Sheibani

  2. Department of Clinical Toxicology, School of Medicine, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 19839-63113, Tehran, Islamic Republic of Iran

    Nasim Zamani & Hossein Hassanian-Moghaddam

  3. Department of Clinical Toxicology, Loghman-Hakim Hospital, Kamali Street, South Karegar Avenue, 1333431151, Tehran, Islamic Republic of Iran

    Hossein Hassanian-Moghaddam

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  1. Mehdi Sheibani
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Correspondence to Hossein Hassanian-Moghaddam.

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Handling Editor: Shazina Saeed.

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Sheibani, M., Zamani, N. & Hassanian-Moghaddam, H. Electrocardiographic Findings in Mortalities Due to Pure Methadone Toxicity. Cardiovasc Toxicol 19, 62–71 (2019). https://doi.org/10.1007/s12012-018-9474-y

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  • DOI: https://doi.org/10.1007/s12012-018-9474-y

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