Calcium Channel Blockers No Help in Older Patients with Heart Failure and Preserved Ejection Fraction

By Reuters Staff

NEW YORK - Older patients with heart failure and preserved ejection fraction (HFpEF) who are put on calcium channel blockers experience neither improvement nor worsening of clinical outcomes, according to a new registry study.

Some small studies have suggested that calcium channel blockers (CCBs) can improve exercise capacity, diastolic function, and heart failure scores in HFpEF patients. But their effect on clinical outcomes remains unclear, Dr. Ali Ahmed from Washington DC VA Medical Center and colleagues write in Circulation Heart Failure, online October 8.

The researchers used data from OPTIMIZE-HF, a national registry of hospitalized heart failure patients, along with Medicare claims data, to examine the clinical effectiveness of CCBs in a study of 810 propensity-matched pairs of older patients with HFpEF.

The primary composite endpoint of all-cause mortality or heart failure hospitalization occurred with the same frequency whether or not patients received CCBs (82% vs. 81%, p=0.638).

CCB use also had no influence on the individual components of all-cause mortality and hospitalization, the researchers say.

Even among 7,514 unmatched patients, there was no significant difference between CCB-treated and CCB-untreated patients in the risk of all-cause mortality or heart failure hospitalizations.

Moreover, there were no differences in outcomes when analyzed by CCB class.

"These findings suggest that the negative inotropic and chronotropic effects of CCBs had no negative association with outcomes in HFpEF," the researchers note.

"In conclusion," they add, "in real-world hospitalized older HFpEF patients not receiving prior CCBs, a new discharge prescription for CCBs had no associations with the primary composite endpoint of total mortality or HF hospitalization and individual endpoints of mortality or hospitalization, regardless of the class of CCBs."

Dr. Ahmed did not respond to a request for comments.

SOURCE: https://bit.ly/1vLRxRw

Circ Heart Fail 2014.

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