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Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation
Background and Objective Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced eject...
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| Published in: | Clinical drug investigation 2018-06, Vol.38 (6), p.503-508 |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c372t-55c528ca094ce13bdaac222066994c3f75e25da31eab92f67a268e01b176915c3 |
| container_end_page | 508 |
| container_issue | 6 |
| container_start_page | 503 |
| container_title | Clinical drug investigation |
| container_volume | 38 |
| creator | Jandali, Mohamad Badr |
| description | Background and Objective
Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced ejection fraction. This study evaluated outcomes in patients who had low ejection fraction and were treated with diltiazem.
Methods
This was a retrospective chart review in 635 patients who were hospitalized because of rapid atrial fibrillation and who were treated with intravenous diltiazem. Outcomes were evaluated for patients in two groups based on ejection fraction (EF): normal (EF ≥ 50%) and low EF (EF |
| doi_str_mv | 10.1007/s40261-018-0631-7 |
| format | article |
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Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced ejection fraction. This study evaluated outcomes in patients who had low ejection fraction and were treated with diltiazem.
Methods
This was a retrospective chart review in 635 patients who were hospitalized because of rapid atrial fibrillation and who were treated with intravenous diltiazem. Outcomes were evaluated for patients in two groups based on ejection fraction (EF): normal (EF ≥ 50%) and low EF (EF < 50%).
Results
There were no differences in frequency of hypotension, intensive care unit transfer, or in-hospital mortality between the two groups. There was a significantly higher frequency of acute kidney injury within 48 h after starting diltiazem in patients who had low (16 patients [10%]) compared with normal EF (17 patients [3.6%]
P
= 0.002).
Conclusions
Intravenous diltiazem in patients who have decreased EF may be associated with increased risk of acute kidney injury, but not increased risk of hypotension, intensive care unit transfer, or in-hospital mortality.</description><identifier>ISSN: 1173-2563</identifier><identifier>EISSN: 1179-1918</identifier><identifier>DOI: 10.1007/s40261-018-0631-7</identifier><identifier>PMID: 29478238</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Cardiac arrhythmia ; Cardiomyopathy ; Cardiovascular disease ; Coronary vessels ; Ejection fraction ; Electrocardiography ; Epidemiology ; Heart attacks ; Heart failure ; Heart rate ; Intensive care ; Internal Medicine ; Kidneys ; Medicine ; Medicine & Public Health ; Mortality ; Original Research Article ; Pharmacology/Toxicology ; Pharmacotherapy ; Studies</subject><ispartof>Clinical drug investigation, 2018-06, Vol.38 (6), p.503-508</ispartof><rights>Springer International Publishing AG, part of Springer Nature 2018</rights><rights>Copyright Springer Science & Business Media Jun 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-55c528ca094ce13bdaac222066994c3f75e25da31eab92f67a268e01b176915c3</citedby><cites>FETCH-LOGICAL-c372t-55c528ca094ce13bdaac222066994c3f75e25da31eab92f67a268e01b176915c3</cites><orcidid>0000-0002-0842-2609</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29478238$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jandali, Mohamad Badr</creatorcontrib><title>Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation</title><title>Clinical drug investigation</title><addtitle>Clin Drug Investig</addtitle><addtitle>Clin Drug Investig</addtitle><description>Background and Objective
Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced ejection fraction. This study evaluated outcomes in patients who had low ejection fraction and were treated with diltiazem.
Methods
This was a retrospective chart review in 635 patients who were hospitalized because of rapid atrial fibrillation and who were treated with intravenous diltiazem. Outcomes were evaluated for patients in two groups based on ejection fraction (EF): normal (EF ≥ 50%) and low EF (EF < 50%).
Results
There were no differences in frequency of hypotension, intensive care unit transfer, or in-hospital mortality between the two groups. There was a significantly higher frequency of acute kidney injury within 48 h after starting diltiazem in patients who had low (16 patients [10%]) compared with normal EF (17 patients [3.6%]
P
= 0.002).
Conclusions
Intravenous diltiazem in patients who have decreased EF may be associated with increased risk of acute kidney injury, but not increased risk of hypotension, intensive care unit transfer, or in-hospital mortality.</description><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular disease</subject><subject>Coronary vessels</subject><subject>Ejection fraction</subject><subject>Electrocardiography</subject><subject>Epidemiology</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Intensive care</subject><subject>Internal Medicine</subject><subject>Kidneys</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original Research Article</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacotherapy</subject><subject>Studies</subject><issn>1173-2563</issn><issn>1179-1918</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kUFv1DAQhS1ERUvhB3BBlrhwCfXYie0cq9KllSpVKnC2Js4EvMomi-2Ayq_HSwpISD155PnmzbMfY69AvAMhzFmqhdRQCbCV0Aoq84SdAJi2ghbs09-1qmSj1TF7ntJWCNCg5TN2LNvaWKnsCQsfcaB8z-eBX0854nea5iXx92HMAX_SjoeJ31G_eOr55ZZ8DvPENxHX4oowZr7BMC6R-I-Qv_I73Ieen-cYcOSb0MUwjniAX7CjAcdELx_OU_Z5c_np4qq6uf1wfXF-U3llZK6axjfSehRt7QlU1yN6KaXQui03ajANyaZHBYRdKwdtUGpLAjowuoXGq1P2dtXdx_nbQim7XUieiouJytOcFMIqrayBgr75D93OS5yKOyehFlZbVTeFgpXycU4p0uD2Meww3jsQ7pCDW3NwJQd3yMGZMvP6QXnpdtT_nfjz8QWQK5BKa_pC8d_qx1V_ATmikjI</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Jandali, Mohamad Badr</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0842-2609</orcidid></search><sort><creationdate>20180601</creationdate><title>Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation</title><author>Jandali, Mohamad Badr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-55c528ca094ce13bdaac222066994c3f75e25da31eab92f67a268e01b176915c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular disease</topic><topic>Coronary vessels</topic><topic>Ejection fraction</topic><topic>Electrocardiography</topic><topic>Epidemiology</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Intensive care</topic><topic>Internal Medicine</topic><topic>Kidneys</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original Research Article</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacotherapy</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jandali, Mohamad Badr</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical drug investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jandali, Mohamad Badr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation</atitle><jtitle>Clinical drug investigation</jtitle><stitle>Clin Drug Investig</stitle><addtitle>Clin Drug Investig</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>38</volume><issue>6</issue><spage>503</spage><epage>508</epage><pages>503-508</pages><issn>1173-2563</issn><eissn>1179-1918</eissn><abstract>Background and Objective
Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced ejection fraction. This study evaluated outcomes in patients who had low ejection fraction and were treated with diltiazem.
Methods
This was a retrospective chart review in 635 patients who were hospitalized because of rapid atrial fibrillation and who were treated with intravenous diltiazem. Outcomes were evaluated for patients in two groups based on ejection fraction (EF): normal (EF ≥ 50%) and low EF (EF < 50%).
Results
There were no differences in frequency of hypotension, intensive care unit transfer, or in-hospital mortality between the two groups. There was a significantly higher frequency of acute kidney injury within 48 h after starting diltiazem in patients who had low (16 patients [10%]) compared with normal EF (17 patients [3.6%]
P
= 0.002).
Conclusions
Intravenous diltiazem in patients who have decreased EF may be associated with increased risk of acute kidney injury, but not increased risk of hypotension, intensive care unit transfer, or in-hospital mortality.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>29478238</pmid><doi>10.1007/s40261-018-0631-7</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-0842-2609</orcidid></addata></record> |
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| ispartof | Clinical drug investigation, 2018-06, Vol.38 (6), p.503-508 |
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| language | eng |
| recordid | cdi_proquest_miscellaneous_2008363871 |
| source | Springer Nature |
| subjects | Cardiac arrhythmia Cardiomyopathy Cardiovascular disease Coronary vessels Ejection fraction Electrocardiography Epidemiology Heart attacks Heart failure Heart rate Intensive care Internal Medicine Kidneys Medicine Medicine & Public Health Mortality Original Research Article Pharmacology/Toxicology Pharmacotherapy Studies |
| title | Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation |
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