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Influence of dihydropyridines class of calcium channel blockers in iron deficiency in patients with heart failure with reduced ejection fraction
Session:
Comunicações Orais - Sessão 01 - Insuficiência Cardíaca: a clínica primeiro
Speaker:
Rui Carlos Gregório Antunes Coelho
Congress:
CPC 2023
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Rui Antunes Coelho; Ana Rita Piteira; Jéni Quintal; Sara Gonçalves; Tatiana Duarte; Pedro Carreira; Margarida Madeira; Hugo Viegas; Ana Sousa; Crisálida Ferreira; Andreia Soares; Dina Ferreira; Ana Fátima Esteves; António Pinheiro; Joana Silva Ferreira; Pedro Amador; Ermelinda Pedroso; Rui Caria
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Background:</u></strong> Iron deficiency (ID) is a recognized factor associated with worse prognosis of heart failure (HF) but the mechanism by which the patients develop ID is still unclear. Some studies suggest a relationship between ID and therapy used in the clinical control of HF. Hypertension is one of the most frequent etiologies and comorbidities of HF, whereby many patients with HF are medicated with Calcium Channel Blockers from the class of dihydropyridines (D-BCC). A single study evaluated the impact of medication on patients with HF and established a statistically significant relationship between D-BCC and ID. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Purpose:</u></strong> The aim of this study was to verify if therapy with D-BCC is indeed associated with ID in patients with HF with reduced ejection fraction (EFrHF). </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Methods:</u></strong> We performed a retrospective observational cohort study of all patients with EFrHF followed at our HF Unit, between January 2019 and December 2020. Patients with severe anemia or conditions that may cause anaemia/ ID were excluded. Of a total of 100 patients that were included, 30 patients were medicated with D-BCC for at least 3 months<span style="color:#ed7d31">.</span> We compared ID (ferritin <100 µg/L or ferritin 100-300 µg/L and transferrin saturation <20%) of at least 6-months follow-up as well as other patient characteristics between the groups. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Results:</u></strong> Taking D-BCC (n = 30) had a statistically significant association with ID (73.3% in D-BCC group vs 45.2% in control group; p = 0.006). Most of these patients (n = 17; 57%) were taking amlodipine, 11 patients (37%) were taking lercanidipine and 1 patient (3,3%) was on nifedipine. 17 of these patients (45%) were on the lowest dose of these drugs. Neither the active principle nor the dose had a statistically significant relationship with the development of ID. The group on D-BCC had a slightly higher EF (37% vs 35%; p = 0.02) and higher levels of corrected calcium to albumin (9,7 mg/dL vs 9,3 mg/dL, p = 0,02). </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Conclusions:</u></strong> In a population of 100 patients with EFrHF, the intake of D-BCC is used, as expected, mainly to control hypertension and is significantly associated with a higher incidence of ID in the follow-up at 6 months - 1 year, but not to the development of anemia, NYHA class, hospitalizations for HF or 2-years mortality. If this association is confirmed in more robust studies, the therapeutic and prognostic implication of these drugs could lead to a review of clinical practice, with greater vigilance and attention for this possible drug effect that can be controlled, allowing an intervention early prognosis in these patients.</span></span></p>
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