title: Alcohol withdrawal prevention: a randomized evaluation of lorazepam and ethanol--a pilot study.
abstract: BACKGROUND
  Alcohol withdrawal syndrome, characterized by confusion, agitation, and hallucinations, decreases the safety of patients with acute myocardial infarction. Unexpected hospitalization and sudden cessation of alcohol consumption may increase in-hospital complications and length of stay and even precipitate death.
  
  
  OBJECTIVE
  To perform a randomized evaluation of lorazepam and ethanol/lorazepam to evaluate the safety and efficacy of these 2 strategies for preventing alcohol withdrawal syndrome in patients with acute coronary syndromes.
  
  
  METHODS
  Patients (n = 57) with myocardial infarction were screened for alcohol dependence by using the CAGE questionnaire and randomized to treatment with lorazepam or ethanol with lorazepam. Demographics and complication rates were analyzed by using χ² tests (categorical variables) and t tests (continuous variables). Safety (composite complication rates) of the treatment strategy was evaluated by using the Fisher exact test, and length of stay by using the Wilcoxon rank-sum test.
  
  
  RESULTS
  Safety-associated complication rates (self-extubation, delirium tremens, reinfarction) did not differ between groups (24% lorazepam vs 18% ethanol; P = .56). Days spent in the cardiac intensive care unit (7% lorazepam vs 2% ethanol; P = .32) and overall hospital stay (6% lorazepam vs 6% ethanol; P = .72) did not differ between the 2 groups.
  
  
  CONCLUSIONS
  These preliminary findings suggest that a randomized evaluation of treatment strategies to prevent complications associated with alcohol withdrawal in patients with acute myocardial infarction is safe and feasible.
authors.affiliation: Cardiac Intensive Care Unit, Duke University Hospital, Durham, NC, USA.
authors.forename: Joyce E
authors.initials: JE
authors.lastname: Fullwood
authors.forename: Zhila
authors.initials: Z
authors.lastname: Mostaghimi
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Washam
authors.forename: Wanda
authors.initials: W
authors.lastname: Bride
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Bradi B
authors.initials: BB
authors.lastname: Granger
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D002492:Central Nervous System Depressants / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007362:Intensive Care Units; D007902:Length of Stay; D008140:Lorazepam / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D000431:Ethanol; D008140:Lorazepam