Key result
Pregabalin is linked to reversible acute decompensated heart failure and acute kidney injury in mild HF.
Why the study?
There are few reports addressing a possible relationship between pregabalin and heart failure despite its common use in patients with neuropathic pain.
Case Report (n=1)
Pregabalin may induce acute decompensated heart failure even in patients with mild (NYHA class I) heart failure, suggesting caution is needed across all NYHA classes, especially with renal impairment.
May warrant vigilance with pregabalin in heart failure patients with renal impairment; hypothesis-generating for causality and needs prospective confirmation.
Pregabalin is a drug widely used in patients with neuropathic pain.While it may cause common adverse events such as dizziness, somnolence and peripheral edema, there are a few reports addressing a possible relationship between pregabalin and heart failure.Here we report an elderly woman with a history of heart failure New York Heart Association (NYHA) class I who was taking pregabalin presented with acute decompensated heart failure and acute kidney injury.With discontinuation of pregabalin and supportive treatment, patient's symptoms improved rapidly and she was discharged well.Though exact mechanism is still unclear, it is believed that antagonism of the L-type calcium channels in vasculature plays a role in pregabalin induced heart failure.Current American Heart Association (AHA) guideline recommends prescribing pregabalin with caution in patients with NYHA class III to IV heart failure.From this case report, we would suggest to use pregabalin cautiously in all patients with history of heart failure (NYHA class I to IV) especially when there is co-existing renal impairment.
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LYU et al. (2017) conducted a case report in Heart failure (n=1). Pregabalin was evaluated on Acute decompensated heart failure and acute kidney injury. Pregabalin use in an elderly woman with NYHA class I heart failure was associated with acute decompensated heart failure and acute kidney injury, which improved rapidly upon drug discontinuation.
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