Skip to main content

Drugs to Avoid in Acute Decompensated Heart Failure (ADHF): Contraindicated Medications and Interactions

  • 1089 Accesses

Part of the Contemporary Cardiology book series (CONCARD)

Abstract

Following diuretics, vasodilators are the most commonly used intravenous (IV) therapy for acute decompensated heart failure (ADHF), but strong evidence is lacking for the use of nitrates, nitroprusside, and nesiritide on clinical outcomes and therefore these drugs are most commonly used for symptomatic improvement. The long-term use of angiotensin converting enzyme (ACE) inhibitors is associated with improved symptoms and lower mortality in patients with systolic heart failure. However, the benefits of early IV ACE inhibitors in ADHF have not been established and may actually be harmful. In the CONSENSUS 2 trial, early IV enalapril was studied in patients with acute myocardial infarction (AMI). In patients with AMI and ADHF, IV enalapril was associated with decreased survival 180 days after AMI. The American College of Emergency Physicians supports the early use of IV ACE inhibitors, while the European Society of Cardiology does not. Until studied further, IV ACE inhibitors should be avoided in the setting of ADHF.

Keywords

  • Nonsteroidal anti-inflammatory medication
  • Calcium channel blockers
  • Antiarrhythmics
  • Thiazolidinediones
  • Inotropes

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-44006-4_20
  • Chapter length: 8 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-44006-4
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   149.99
Price excludes VAT (USA)
Hardcover Book
USD   149.99
Price excludes VAT (USA)

References

  1. Singh A, et al. Agents with vasodilator properties in acute heart failure. Eur Heart J. 2016:1–12.

    Google Scholar 

  2. Swedberg K, et al. Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction. Results of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II). N Engl J Med. 1992;327(10):678–84.

    CAS  CrossRef  PubMed  Google Scholar 

  3. Silvers SM, et al. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute heart failure syndromes. Ann Emerg Med. 2007;49(5):627–69.

    CrossRef  PubMed  Google Scholar 

  4. Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29(19):2388–442.

    CAS  CrossRef  PubMed  Google Scholar 

  5. Mullens W, et al. Sodium nitroprusside for advanced low-output heart failure. J Am Coll Cardiol. 2008;52(3):200–7.

    CAS  CrossRef  PubMed  Google Scholar 

  6. Cohn JN, et al. Effect of short-term infusion of sodium nitroprusside on mortality rate in acute myocardial infarction complicated by left ventricular failure: results of a Veterans Administration cooperative study. N Engl J Med. 1982;306(19):1129–35.

    CAS  CrossRef  PubMed  Google Scholar 

  7. Sackner-Bernstein JD, Skopicki HA, Aaronson KD. Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure. Circulation. 2005;111(12):1487–91.

    CAS  CrossRef  PubMed  Google Scholar 

  8. Sackner-Bernstein JD, et al. Short-term risk of death after treatment with nesiritide for decompensated heart failure: a pooled analysis of randomized controlled trials. JAMA. 2005;293(15):1900–5.

    CAS  CrossRef  PubMed  Google Scholar 

  9. Whellan DJ, et al. Dichotomous relationship between age and 30-day death or rehospitalization in heart failure patients admitted with acute decompensated heart failure: results from the ASCEND-HF trial. J Card Fail. 2016;22(6):409–16.

    CrossRef  PubMed  Google Scholar 

  10. Kitai T, Tang WW. Recent advances in treatment of heart failure. F1000Res. 2015;4:1–8.

    Google Scholar 

  11. Chen HH, et al. Targeting the kidney in acute heart failure: can old drugs provide new benefit? Renal Optimization Strategies Evaluation in Acute Heart Failure (ROSE AHF) trial. Circ Heart Fail. 2013;6(5):1087–94.

    CrossRef  PubMed  Google Scholar 

  12. Goldstein RE, et al. Diltiazem increases late-onset congestive heart failure in postinfarction patients with early reduction in ejection fraction. The Adverse Experience Committee; and the Multicenter Diltiazem Postinfarction Research Group. Circulation. 1991;83(1):52–60.

    CAS  CrossRef  PubMed  Google Scholar 

  13. Elkayam U, et al. Calcium channel blockers in heart failure. J Am Coll Cardiol. 1993;22(4 Suppl A):139a–44.

    CAS  CrossRef  PubMed  Google Scholar 

  14. Elkayam U, et al. A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure. Circulation. 1990;82(6):1954–61.

    CAS  CrossRef  PubMed  Google Scholar 

  15. Prins KW, et al. Effects of beta-blocker withdrawal in acute decompensated heart failure: a systematic review and meta-analysis. JACC Heart Fail. 2015;3(8):647–53.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  16. Kottkamp H, et al. Clinical significance and management of ventricular arrhythmias in heart failure. Eur Heart J. 1994;15(Suppl D):155–63.

    CrossRef  PubMed  Google Scholar 

  17. Amabile CM, Spencer AP. Keeping your patient with heart failure safe: a review of potentially dangerous medications. Arch Intern Med. 2004;164(7):709–20.

    CrossRef  PubMed  Google Scholar 

  18. Echt DS, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991;324(12):781–8.

    CAS  CrossRef  PubMed  Google Scholar 

  19. Hallstrom AP, et al. Time to arrhythmic, ischemic, and heart failure events: exploratory analyses to elucidate mechanisms of adverse drug effects in the Cardiac Arrhythmia Suppression Trial. Am Heart J. 1995;130(1):71–9.

    CAS  CrossRef  PubMed  Google Scholar 

  20. Hunt SA, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2001;38(7):2101–13.

    CAS  CrossRef  PubMed  Google Scholar 

  21. Konstantinou DM, Karvounis H, Giannakoulas G. Digoxin in heart failure with a reduced ejection fraction: a risk factor or a risk marker? Cardiology. 2016;134(3):311–9.

    CAS  CrossRef  PubMed  Google Scholar 

  22. Spargias KS, Hall AS, Ball SG. Safety concerns about digoxin after acute myocardial infarction. Lancet. 1999;354(9176):391–2.

    CAS  CrossRef  PubMed  Google Scholar 

  23. McClements BM, Adgey AA. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute myocardial infarction in the thrombolytic era. J Am Coll Cardiol. 1993;21(6):1419–27.

    CAS  CrossRef  PubMed  Google Scholar 

  24. Khand AU, et al. Systematic review of the management of atrial fibrillation in patients with heart failure. Eur Heart J. 2000;21(8):614–32.

    CAS  CrossRef  PubMed  Google Scholar 

  25. Petersen JW, Felker GM. Inotropes in the management of acute heart failure. Crit Care Med. 2008;36(1 Suppl):S106–11.

    CAS  CrossRef  PubMed  Google Scholar 

  26. Katz AM. Potential deleterious effects of inotropic agents in the therapy of chronic heart failure. Circulation. 1986;73(3 Pt 2):III184–90.

    CAS  PubMed  Google Scholar 

  27. Packer M, et al. Double-blind, placebo-controlled study of the efficacy of flosequinan in patients with chronic heart failure. Principal Investigators of the REFLECT Study. J Am Coll Cardiol. 1993;22(1):65–72.

    CAS  CrossRef  PubMed  Google Scholar 

  28. Cuffe MS, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287(12):1541–7.

    CAS  CrossRef  PubMed  Google Scholar 

  29. Follath F, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002;360(9328):196–202.

    CAS  CrossRef  PubMed  Google Scholar 

  30. O’Connor CM, et al. Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flolan International Randomized Survival Trial (FIRST). Am Heart J. 1999;138(1 Pt 1):78–86.

    CrossRef  PubMed  Google Scholar 

  31. Caldicott LD, et al. Intravenous enoximone or dobutamine for severe heart failure after acute myocardial infarction: a randomized double-blind trial. Eur Heart J. 1993;14(5):696–700.

    CAS  CrossRef  PubMed  Google Scholar 

  32. Burger AJ, et al. Effect of nesiritide (B-type natriuretic peptide) and dobutamine on ventricular arrhythmias in the treatment of patients with acutely decompensated congestive heart failure: the PRECEDENT study. Am Heart J. 2002;144(6):1102–8.

    CAS  CrossRef  PubMed  Google Scholar 

  33. Lowes BD, et al. Milrinone versus dobutamine in heart failure subjects treated chronically with carvedilol. Int J Cardiol. 2001;81(2–3):141–9.

    CAS  CrossRef  PubMed  Google Scholar 

  34. Metra M, et al. Beta-blocker therapy influences the hemodynamic response to inotropic agents in patients with heart failure: a randomized comparison of dobutamine and enoximone before and after chronic treatment with metoprolol or carvedilol. J Am Coll Cardiol. 2002;40(7):1248–58.

    CAS  CrossRef  PubMed  Google Scholar 

  35. Bohm M, et al. Improvement of postreceptor events by metoprolol treatment in patients with chronic heart failure. J Am Coll Cardiol. 1997;30(4):992–6.

    CAS  CrossRef  PubMed  Google Scholar 

  36. Thackray S, et al. The effectiveness and relative effectiveness of intravenous inotropic drugs acting through the adrenergic pathway in patients with heart failure-a meta-regression analysis. Eur J Heart Fail. 2002;4(4):515–29.

    CAS  CrossRef  PubMed  Google Scholar 

  37. Loh E, et al. A randomized multicenter study comparing the efficacy and safety of intravenous milrinone and intravenous nitroglycerin in patients with advanced heart failure. J Card Fail. 2001;7(2):114–21.

    CAS  CrossRef  PubMed  Google Scholar 

  38. Feenstra J, et al. Association of nonsteroidal anti-inflammatory drugs with first occurrence of heart failure and with relapsing heart failure: the Rotterdam Study. Arch Intern Med. 2002;162(3):265–70.

    CAS  CrossRef  PubMed  Google Scholar 

  39. Gislason GH, et al. Increased mortality and cardiovascular morbidity associated with use of nonsteroidal anti-inflammatory drugs in chronic heart failure. Arch Intern Med. 2009;169(2):141–9.

    CAS  CrossRef  PubMed  Google Scholar 

  40. Whitworth JA, et al. The nitric oxide system in glucocorticoid-induced hypertension. J Hypertens. 2002;20(6):1035–43.

    CAS  CrossRef  PubMed  Google Scholar 

  41. Misbin RI. The phantom of lactic acidosis due to metformin in patients with diabetes. Diabetes Care. 2004;27(7):1791–3.

    CrossRef  PubMed  Google Scholar 

  42. Kennedy FP. Do thiazolidinediones cause congestive heart failure? Mayo Clin Proc. 2003;78(9):1076–7.

    CAS  CrossRef  PubMed  Google Scholar 

  43. Hartung DM, et al. Risk of hospitalization for heart failure associated with thiazolidinedione therapy: a medicaid claims-based case–control study. Pharmacotherapy. 2005;25(10):1329–36.

    CAS  CrossRef  PubMed  Google Scholar 

  44. Gamssari F, et al. Rapid ventricular tachycardias associated with cilostazol use. Tex Heart Inst J. 2002;29(2):140–2.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James McCord .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Aurora, L., McCord, J. (2017). Drugs to Avoid in Acute Decompensated Heart Failure (ADHF): Contraindicated Medications and Interactions. In: Peacock, W. (eds) Short Stay Management of Acute Heart Failure. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-44006-4_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44006-4_20

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-44005-7

  • Online ISBN: 978-3-319-44006-4

  • eBook Packages: MedicineMedicine (R0)