Pharmacologic Pitfalls in Heart Failure: A Guide to Drugs that May Cause or Exacerbate Heart Failure. A European Journal of Heart Failure Expert Consensus Document

作者：Amr Abdin, Johann Bauersachs, Magdy Abdelhamid, Suleman Aktaa, Hussam Al Ghorani, Antoni Bayés‐Genís, Jan Biegus, Michael Böhm, Javed Butler, Nicolas Girerd, Marco Metra, Wilfried Müllens, Hadi N. Skouri, Muthiah Vaduganathan, Seif El Hadidi, Giuseppe M.C. Rosano, Gianluigi Savarese · 发表于：European Journal of Heart Failure · 年份：2025 · DOI：10.1002/ejhf.70087 · 被引用次数：4 · 研究领域：Heart Failure Treatment and Management、Cardiac Fibrosis and Remodeling、Diabetes Treatment and Management

Abstract Heart failure (HF) exerts a global health burden, often complicated by polypharmacy due to the frequent coexistence of cardiovascular and non-cardiovascular comorbidities. While guideline-directed medical therapy and devices have significantly improved outcomes, a range of commonly prescribed medications may inadvertently worsen HF or precipitate decompensation. This expert consensus statement provides a comprehensive overview of drugs known to cause or exacerbate HF, offering practical guidance for clinicians to identify and avoid harmful pharmacologic exposures in this vulnerable population. The review examines the pathophysiological mechanisms, clinical evidence, and guideline-based recommendations for several drug classes, including antidiabetic agents (e.g. thiazolidinediones, dipeptidyl peptidase-4 inhibitors), antiarrhythmics (particularly Class I and III), calcium channel blockers, non-steroidal anti-inflammatory drugs, antifungals (e.g. itraconazole, amphotericin B), macrolide antibiotics, antihypertensives (e.g. α1-blockers, centrally acting sympatholytics), neurological and psychiatric medications (e.g. carbamazepine, pregabalin, lithium), and selected anaesthetic and anticancer agents such as anthracyclines and vascular endothelial growth factor inhibitors. Each section addresses clinical scenarios where these medications may be contraindicated or require close monitoring. Importantly, this document emphasizes the need for individualized therapy, close re...