Introduction : Cardiotropic agents overuse is correlated to poor prognosis and is related to the risk of cardiac
and hemodynamic life-threatening situations. Toxicity is attributed to their narrow therapeutic spectrum and
pharmacodynamic properties. The aim of this study was to evaluate epidemiological, clinical and prognostic profile
of patients visiting an emergency department and in whom iatrogeny secondary to cardiotropic use was diagnosed.
Methods : This was a single-center prospective study over 12 months. We included, successively, all the patients aged over
18 years in whom diagnosis of cardiotropic iatrogeny was made. Cardiotropic-related drug-induced events were selected
following a collegial decision-making process. Prognosis was evaluated in terms of severity and mortality at day 30.
Results : We enrolled 51 patients. The median age was 72 years with IQR [25-75]. The sex ratio was 0.64. Twenty
cases of misuse were identified (39%) with 51% of the cases being related to the physician. Accountability of the
adverse drug event (ADE) was 51%. The ADE was considered severe in 45% of the cases and the death rate within the
first 30 days was 12%. Drug classes were dominated by beta-blockers in 20 patients (39%). They were significantly
the most incriminated agent in the occurrence of severe ADE. A double iatrogeny was found in 13 patients (25%).
Misuse and physician-related ADE were found to be predictive of the severity of ADE in univariate analysis with,
respectively, for misuse: (OR brut=22, CI95%=[5.2;93.5]; p < 0.001) and for related physician ADE (OR brut = 3.7;
CI95%=[1.11;12] ; p= 0.015). Predictive factors of mortality within the first 30 days in the univariate analysis were:
Past renal failure: OR 5.8; CI95% [1.29-26.5]; p=0.015; Misuse with OR =16.7; 95% CI=[1.9-143.5]; p=0.002 and
severe ADE with OR =15.0; 95% CI=[1.75-129]; p=0.032.
Conclusion : Cardiotropic iatrogeny is frequent and serious because of its hemodynamic repercussions responsible
for a high rate of hospitalizations and mortality. ADE is preventable in 50% of the cases and related to prescription.
Preventability of ADE is possible well before the arrival of the patient at the Emergency Department (ED).