Pharmacologic Pitfalls in Heart Failure: A Guide to Drugs that May Cause or Exacerbate Heart Failure. A European Journal of Heart Failure Expert Consensus Document
Abstract
Abstract Heart failure (HF) exerts a global health burden, often complicated by polypharmacy due to the frequent coexistence of cardiovascular and non-cardiovascular comorbidities. While guideline-directed medical therapy and devices have significantly improved outcomes, a range of commonly prescribed medications may inadvertently worsen HF or precipitate decompensation. This expert consensus statement provides a comprehensive overview of drugs known to cause or exacerbate HF, offering practical guidance for clinicians to identify and avoid harmful pharmacologic exposures in this vulnerable population. The review examines the pathophysiological mechanisms, clinical evidence, and guideline-based recommendations for several drug classes, including antidiabetic agents (e.g. thiazolidinediones, dipeptidyl peptidase-4 inhibitors), antiarrhythmics (particularly Class I and III), calcium channel blockers, non-steroidal anti-inflammatory drugs, antifungals (e.g. itraconazole, amphotericin B), macrolide antibiotics, antihypertensives (e.g. α1-blockers, centrally acting sympatholytics), neurological and psychiatric medications (e.g. carbamazepine, pregabalin, lithium), and selected anaesthetic and anticancer agents such as anthracyclines and vascular endothelial growth factor inhibitors. Each section addresses clinical scenarios where these medications may be contraindicated or require close monitoring. Importantly, this document emphasizes the need for individualized therapy, close…
Read the paper
Related studies
- Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions
- Clinical challenges treatingStenotrophomonas maltophiliainfections: an update
- Guidelines on Implementing Antimicrobial Stewardship Programs in Korea
- Multidrug Resistant Pseudomonas aeruginosa in Clinical Settings: A Review of Resistance Mechanisms and Treatment Strategies
- What’s old is new again: Insights into diabetic foot microbiome
- Multidrug resistant (or antimicrobial-resistant) pathogens - alternatives to new antibiotics?
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.