Benzodiazepine use and mortality in chronic heart failure

Area of Science:

• Cardiology
• Pharmacology
• Geriatrics

Background:

• The prognostic implications of benzodiazepine (BZD) use in heart failure (HF) patients remain unclear.
• Understanding these risks is crucial for optimizing treatment in this vulnerable population.

Purpose of the Study:

• To assess the association between benzodiazepine (BZD) use and all-cause mortality in ambulatory patients with chronic heart failure (HF).

Main Methods:

• Retrospective cohort study of 854 ambulatory HF patients with left ventricular systolic dysfunction (LVSD).
• Cox regression analysis and multivariable models were used to evaluate the association between BZD use and all-cause mortality, with subgroup analyses for age, sex, BMI, respiratory disease, CKD, and NYHA class.

Main Results:

• BZD use was not associated with increased mortality in the overall cohort or in most subgroups.
• However, in patients over 75 years old and those with chronic kidney disease (CKD), BZD use was associated with a trend towards (P=0.06) and significantly increased (P=0.02) all-cause mortality, respectively.
• Multivariable analysis revealed an independent association between BZD use and a 36% increased risk of death (HR, 1.36; 95% CI, 1.06-1.75).

Conclusions:

• Benzodiazepine (BZD) use in heart failure (HF) patients is independently associated with an increased risk of all-cause mortality.
• Caution is recommended when prescribing BZD, particularly to elderly HF patients and those with chronic kidney disease (CKD).