Pharmacologic pitfalls in heart failure: A guide to drugs that may cause or exacerbate heart failure. A European Journal of Heart Failure expert consensus document
Amr Abdin, Johann Bauersachs, Magdy Abdelhamid, Suleman Aktaa, Hussam Al Ghorani, Antonio Bayes‐Genis, Jan Biegus, Michael Böhm, Javed Butler, Nicolas Girerd, Marco Metra, Wilfried Mullens, Hadi Skouri, Muthiah Vaduganathan, Seif El Hadidi, Giuseppe M.C. Rosano
TL;DR
This paper identifies medications that can worsen heart failure and provides guidance for clinicians to avoid harmful drug use in patients with heart failure.
Contribution
The paper offers a comprehensive, expert consensus on drugs that may cause or exacerbate heart failure, emphasizing clinical scenarios and management strategies.
Findings
Several drug classes, including antidiabetic agents and antiarrhythmics, may worsen heart failure.
Clinicians should review medication regimens to avoid iatrogenic harm in heart failure patients.
Individualized therapy and close monitoring are emphasized to prevent drug-induced deterioration.
Abstract
Heart failure (HF) exerts a global health burden, often complicated by polypharmacy due to the frequent coexistence of cardiovascular and non‐cardiovascular comorbidities. While guideline‐directed medical therapy and devices have significantly improved outcomes, a range of commonly prescribed medications may inadvertently worsen HF or precipitate decompensation. This expert consensus statement provides a comprehensive overview of drugs known to cause or exacerbate HF, offering practical guidance for clinicians to identify and avoid harmful pharmacologic exposures in this vulnerable population. The review examines the pathophysiological mechanisms, clinical evidence, and guideline‐based recommendations for several drug classes, including antidiabetic agents (e.g. thiazolidinediones, dipeptidyl peptidase‐4 inhibitors), antiarrhythmics (particularly Class I and III), calcium channel…
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Taxonomy
TopicsHeart Failure Treatment and Management · Cardiac Fibrosis and Remodeling · Diabetes Treatment and Management