Drug-Induced Heart Failure (Part 1: The Urgency of the Problem, the Prevalence, the Effect of Certain Groups of Drugs on the Risk of Development/Progression Heart Failure)

Abstract

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.

Keywords

• heart failure
• drug-induced heart failure
• calcium channel blockers
• beta-blockers
• antiarrhythmics
• hypoglycemic drugs
• anthracyclines
• anticancer drugs
• non-steroidal anti-infl ammatory drugs