Key result
Certain CCBs, antiarrhythmics, hypoglycemics, anthracyclines, and NSAIDs can provoke heart failure onset or progression.
Why the study?
Certain drug classes can provoke or worsen heart failure, necessitating an analysis and systematisation of data on risk factors and prevalence across various medicines.
Do certain classes of drugs increase the risk of development or progression of heart failure?
Do certain classes of drugs increase the risk of development or progression of heart failure?
Clinicians should be aware of the potential for certain drug classes to induce or worsen heart failure, particularly in patients with pre-existing left ventricular dysfunction, to facilitate timely diagnosis and prevention.
Alerts clinicians to monitor for drug-induced heart failure; leaves open prospective validation of specific risks and mitigation.
Despite all the achievements of modern medicine, heart failure remains one of the most prevalent, severe and prognostically unfavorable conditions that requires close attention of the medical community. The diversity of the clinical picture and the large number of co-morbidities go hand in hand with a rather complicated pharmacotherapy regimen which, in the vast majority of cases, includes several medicines. Some classes of drugs can provoke the onset/progression of heart failure in patients with left ventricular dysfunction, as well as contribute to the development of heart failure in patients without concomitant cardiovascular diseases. The aim of the study was to analyse and systematise data on risk factors for the development of drug-induced heart failure and data on its prevalence when using various groups of medicines. It has been established that drug-induced heart failure typically develops in association with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers (propranolol), antiarrhythmic drugs (disopyramide, dronedarone, lidocaine, lorcainide, mexiletine, moricizine, propafenone, tocainide, flecainide, encainide), hypoglycemic drugs (rosiglitazone, pioglitazone, saxagliptin), anthracyclines (doxorubicin, epirubicin) and other anticancer drugs (bevacizumab, infliximab, trastuzumab), and non-steroidal anti-infl ammatory drugs (diclofenac, ibuprofen, celecoxib, rofecoxib). It is assumed that this pathology develops in a small number of patients, mainly those who already have left ventricular dysfunction. However, the effects of drugs should be considered as one of potential and preventable causes of heart failure development/progression. Raising clinicians’ awareness of the potential adverse effects of individual medicines or entire pharmacological classes of drugs on the cardiac function, especially in patients with left ventricle dysfunction, can facilitate the timely diagnosis and prevention of drug-induced heart failure.
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Остроумова et al. (2020) conducted a review in Drug-induced heart failure. Various drug classes (calcium channel blockers, beta-blockers, antiarrhythmics, hypoglycemics, anthracyclines, NSAIDs) was evaluated on Development or progression of drug-induced heart failure. Various drug classes, including specific calcium channel blockers, antiarrhythmics, hypoglycemics, anthracyclines, and NSAIDs, can provoke the onset or progression of heart failure.
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