PMID- 36916509
OWN - NLM
STAT- MEDLINE
DCOM- 20231027
LR  - 20231206
IS  - 1897-9483 (Electronic)
IS  - 0032-3772 (Linking)
VI  - 133
IP  - 10
DP  - 2023 Oct 26
TI  - Benzodiazepine use and mortality in chronic heart failure.
LID - 16464 [pii]
LID - 10.20452/pamw.16464 [doi]
AB  - INTRODUCTION: The prognostic implications of using benzodiazepines (BZD) in heart 
      failure (HF) patients are still unknown. OBJECTIVES: This study aimed to assess 
      the association of BZD use with all‑cause death in ambulatory, chronic HF 
      patients. PATIENTS AND METHODS: We investigated a retrospective cohort of 
      ambulatory HF patients with left ventricular systolic dysfunction (LVSD). The 
      patients were followed up from their first medical appointment until January 2021 
      and all‑cause mortality was the primary end point. The Cox regression analysis 
      was used to assess the association between BZD use and all‑cause mortality. 
      Subgroup analyses were performed considering age, sex, body mass index (BMI), 
      respiratory disease, chronic kidney disease (CKD), and New York Heart Association 
      (NYHA) class. Multivariable models were built to account for confounders. 
      RESULTS: We studied 854 patients (69% men), of mean (SD) age 71 (13) years, of 
      whom 51% had severe LSVD, and 242 (28.3%) regularly used BZD. During a median 
      follow‑up of 46 months, 443 patients (51.9%) died. BZD use predicted no crude 
      survival disadvantage in the entire investigated group and in the subgroup 
      analysis according to sex, respiratory disease, BMI, and NYHA class. BZD use was 
      not mortality‑associated among patients aged 75 years and younger. However, in 
      those older than 75 years the hazard ratio (HR) of all‑cause death was 1.3 (95% 
      CI, 0.99-1.69; P = 0.06). BZD use seemed safe in the patients without CKD, but in 
      those with CKD it was associated with worse survival (HR, 1.33; 95% CI, 
      1.02-1.73). In a multivariable‑adjusted analysis, the use of BZD was 
      independently associated with increased death risk (HR, 1.36; 95% CI, 1.06-1.75). 
      CONCLUSIONS: The patients medicated with BZD presented a 36% higher risk of 
      dying. BZD should probably be used with caution, particularly in older HF 
      patients and in those with CKD.
FAU - Ribeirinho-Soares, Pedro
AU  - Ribeirinho-Soares P
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
AD  - Department of Medicine, Faculty of Medicine, Porto University, Porto, Portugal
FAU - Madureira, Sergio
AU  - Madureira S
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
FAU - Elias, Catarina
AU  - Elias C
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
FAU - Gouveia, Rita
AU  - Gouveia R
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
FAU - Neves, Ana
AU  - Neves A
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
FAU - Amorim, Marta
AU  - Amorim M
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
AD  - Department of Medicine, Faculty of Medicine, Porto University, Porto, Portugal
AD  - Heart Failure Clinic of the Internal Medicine Department, Sao Joao Hospital 
      Center, Porto, Portugal
FAU - Carreira, Marta S
AU  - Carreira MS
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
AD  - Heart Failure Clinic of the Internal Medicine Department, Sao Joao Hospital 
      Center, Porto, Portugal
FAU - Pereira, Joana
AU  - Pereira J
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
AD  - Department of Medicine, Faculty of Medicine, Porto University, Porto, Portugal
AD  - Heart Failure Clinic of the Internal Medicine Department, Sao Joao Hospital 
      Center, Porto, Portugal
FAU - Almeida, Jorge
AU  - Almeida J
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal
AD  - Department of Medicine, Faculty of Medicine, Porto University, Porto, Portugal
AD  - Cardiovascular Research and Development Unit (UnIC), Porto, Portugal
FAU - Lourenco, Patricia
AU  - Lourenco P
AD  - Internal Medicine Department, Sao Joao Hospital Center, Porto, Portugal; 
      Department of Medicine, Faculty of Medicine, Porto University, Porto, Portugal; 
      Heart Failure Clinic of the Internal Medicine Department, Sao Joao Hospital 
      Center, Porto, Portugal; Cardiovascular Research and Development Unit (UnIC), 
      Porto, Portugal. pamlourenco@yahoo.com
LA  - eng
PT  - Journal Article
DEP - 20230314
PL  - Poland
TA  - Pol Arch Intern Med
JT  - Polish archives of internal medicine
JID - 101700960
RN  - 12794-10-4 (Benzodiazepines)
SB  - IM
CIN - Pol Arch Intern Med. 2023 Oct 26;133(10):. PMID: 37880939
MH  - Male
MH  - Humans
MH  - Aged
MH  - Female
MH  - Retrospective Studies
MH  - Benzodiazepines/adverse effects
MH  - *Heart Failure
MH  - Chronic Disease
MH  - *Renal Insufficiency, Chronic/drug therapy/complications
EDAT- 2023/03/15 06:00
MHDA- 2023/10/27 06:42
CRDT- 2023/03/14 06:46
PHST- 2023/10/27 06:42 [medline]
PHST- 2023/03/15 06:00 [pubmed]
PHST- 2023/03/14 06:46 [entrez]
AID - 16464 [pii]
AID - 10.20452/pamw.16464 [doi]
PST - ppublish
SO  - Pol Arch Intern Med. 2023 Oct 26;133(10):16464. doi: 10.20452/pamw.16464. Epub 
      2023 Mar 14.