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Sleeping pills increased CV events in patients with HFpEF
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Patients with HF with preserved ejection fraction, or HFpEF, had an eightfold greater risk for CV events if they used sleeping pills, according to findings presented at the Heart Failure Congress 2014.
Patients with HF with reduced ejection fraction, or HFrEF, were at elevated risk for CV events if they were not prescribed ACE inhibitors or angiotensin receptor blockers, the researchers found.
Masahiko Setoguchi, MD, from Social Insurance General Central Hospital, Tokyo, and colleagues retrospectively analyzed the medical records of 111 patients with first-onset HF admitted to Tokyo Yamate Medical Center from 2011 to 2013 to determine which drugs prescribed at discharge were associated with major adverse CV events and readmission for HF.
Patients were stratified by ejection fraction (HFpEF=47; HFrEF=64), with adverse CV events, including CV-related death or readmission for HF at 180 days, as the primary endpoint.
Setoguchi and colleagues found that the primary endpoint occurred in 15 of the 47 patients with HFpEF and in 24 of the 64 patients with HFrEF.
Among patients with HFpEF, there were no differences between those who achieved the primary endpoint and those who did not for any medication prescribed at discharge, except for benzodiazepine hypnotics, which significantly increased risk (HR=8.063; P=.01). Other differences between those who did and did not achieve the primary endpoint included blood sodium levels at admission and blood hemoglobin levels at discharge, the researchers found.
Among patients with HFrEF, those prescribed ACE inhibitors or angiotensin receptor blockers at discharge were less likely to achieve the primary endpoint compared with those who were not (HR=0.234; P=.012).
“Benzodiazepine hypnotics may have cardiodepressant actions,” Setoguchi said in a press release. “They may also exert respiratory depressant actions which could exacerbate sleep-disordered breathing and lead to a worse prognosis. Our results need conformation in larger, prospective studies before [HF] patients can be advised to stop taking sleeping pills. But HFpEF patients who use sleeping pills, particularly those who have sleep disordered breathing, should be carefully monitored.”
For more information:
Setoguchi M. Abstract P450. Presented at: Heart Failure Congress 2014; May 17-20, 2014; Athens, Greece.
Disclosure: Setoguchi reports no relevant financial disclosures.