Determining the Role of Thiamine Deficiency in Systolic Heart Failure: A Meta-Analysis and Systematic Review

• Published in: Journal of cardiac failure Vol. 21; no. 12; pp. 1000 - 1007
• Main Authors: Jain, Ankur, MD, Mehta, Raj, MD, Al-Ani, Mohammad, MD, Hill, James A., MD, MS, FACC, Winchester, David E., MD, MS, FACP, FACC
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2015
• Subjects: Age Distribution; Aged; Aged, 80 and over; Cardiovascular; Case-Control Studies; Comorbidity; Female; heart failure; Heart Failure, Systolic - diagnostic imaging; Heart Failure, Systolic - epidemiology; Heart Failure, Systolic - physiopathology; Humans; Male; meta-analysis; Middle Aged; Observational Studies as Topic; Prevalence; Prognosis; Risk Assessment; Severity of Illness Index; Sex Distribution; Survival Analysis; Thiamine - administration & dosage; Thiamine deficiency; Thiamine Deficiency - blood; Thiamine Deficiency - drug therapy; Thiamine Deficiency - epidemiology; Ultrasonography; meta-analysis; heart failure; Thiamine deficiency
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2015.10.005

Abstract Background Approximately 5.7 million Americans carry the diagnosis of systolic heart failure (HF), a major health care burden. HF is a known manifestation of thiamine deficiency (TD). HF patients are at unique risk for developing TD, which may contribute to further altered cardiac function and symptoms. Methods and Results We performed a systematic review of the literature and a meta-analysis to evaluate the prevalence of TD in HF patients, risk factors for and mechanisms of development of TD in HF population, and outcomes of thiamine supplementation in HF patients. We found 54 studies that met our selection criteria, 9 of which were suitable for meta-analysis. TD is more common in HF patients than control subjects (odds ratio 2.53, 95% confidence interval 1.65–3.87). Diuretic use, changes in dietary habits, and altered thiamine absorption and metabolism were identified as possible mechanisms of TD in HF patients. Small observational studies and randomized control trials suggest that thiamine supplementation in HF population may improve ejection fraction and reduce symptoms. Conclusions Thiamine deficiency is more prevalent in the HF population, and its supplementation may be beneficial. The therapeutic role of thiamine in HF warrants further study.