Heart India (Jan 2019)

Role of thiamine supplementation in the treatment of patients with heart failure: A double-blind randomized controlled trial

  • Shamim Iqbal,
  • Aamir Rashid,
  • Irfan Bhat,
  • Jahangir Rashid,
  • Imran Hafeez,
  • Ajaz Lone,
  • Khurshid Iqbal,
  • Iqbal Dar

DOI
https://doi.org/10.4103/heartindia.heartindia_7_19
Journal volume & issue
Vol. 7, no. 2
pp. 68 – 73

Abstract

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Introduction: The role of thiamine supplementation in heart failure (HF) patients has shown conflicting results and has not been adequately studied. Aims and Objectives: The aim and objective were to determine whether thiamine supplementation will provide clinical, biochemical, and echocardiographic benefit in congestive HF patients. Materials and Methods: In this single-center, double-blind, prospective randomized controlled trial, HF patients with varied etiology were included. Patients were randomly allocated to 1 week of inpatient double-blind intravenous therapy with either placebo or thiamine. Parameters studied included clinical, Echo left ventricular ejection fraction (LVEF), and thiamine pyrophosphate effect (TPPE) levels before/after treatment. After completion of 1-week treatment, all patients were given oral thiamine and evaluated at the outpatient clinic after 6 weeks. Results: A total of fifty patients were studied. There was no difference at baseline in mean age (61.4 ± 7.1 vs. 62.4 ± 8.0 years), sex (males 52% vs. 56%), etiology (idiopathic dilated cardiomyopathy 68% vs. 60%, ischemic heart disease 20% vs. 24%), clinical parameters, TPPE levels (16.4 ± 5.2 vs. 16.2 ± 6.5%), and LVEF (28.1% ± 6.7% vs. 28.3% ± 6.6%) in thiamine as compared to placebo group. After 1 week of treatment, there was significant improvement in systolic blood pressure (119.2 ± 18.3 vs. 106.1 ± 18.9 mmHgP < 0.001), diastolic blood pressure (77.4 ± 8.3 vs. 68.2 ± 9.7 mm HgP < 0.001), heart rate (67.0 ± 8.4 vs. 81.9 ± 10.7P < 0.001), weight (66.2 ± 9.5 vs. 71.2 ± 8.2 kgP < 0.001), 3rd-day urine output (1286.0 ± 505.7 ml vs. 750.0 ± 237.2 ml [P < 0.001]), New York Heart Association class (1.6 ± 0.5 vs. 2.1 ± 0.4P < 0.001), LVEF percentage change (7.0 ± 5.2 vs. 0.7% ± 4.7%P < 0.001), and TPPE levels (6.8% ± 1.5% vs. 16.0% ± 6.7%P < 0.001) in thiamine compared with placebo group. Conclusions: Thiamine supplementation significantly improved clinical and echocardiographic parameters. Thiamine supplementation is cost-effective, is benign, and is easily available with significant clinical benefits.

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