Increased Heart Failure Risk Linked to Pregabalin Use

Recent research has indicated a significant association between the use of Pregabalin and a heightened risk of heart failure, particularly in patients with pre-existing cardiovascular conditions. This finding contrasts with Gabapentin, another anticonvulsant medication commonly prescribed for neuropathic pain.

Anticonvulsants, including Pregabalin and Gabapentin, are often utilized to manage chronic pain conditions when traditional analgesics fail. These medications work by binding to specific subunits (?2?-1 and ?2?-2) of voltage-gated calcium channels, thereby reducing the release of neurotransmitters like glutamate and norepinephrine. However, both drugs can also interact with L-type calcium channels in arterial and cardiac muscle cells, potentially increasing the risk of adverse cardiovascular events.

A recent retrospective cohort study led by researchers at Columbia University explored this issue. The study, published in the journal JAMA Network Open, assessed data from over 246,000 Medicare beneficiaries aged 65 to 89 who were diagnosed with chronic, non-cancer-related pain without a history of heart failure or terminal illnesses.

Of the participants, approximately 18,600 were newly prescribed Pregabalin, while the remaining majority received Gabapentin. The study's findings revealed that older patients taking Pregabalin were approximately 50% more likely to experience heart failure compared to those on Gabapentin.

The researchers monitored hospital admissions for heart failure, emergency department visits, and outpatient occurrences, controlling for influential factors such as age, existing health conditions, and medication use to create comparable groups for analysis.

This research highlights the need for clinicians to carefully evaluate the risks versus benefits when prescribing Pregabalin, especially for older adults or those with existing heart conditions. As healthcare providers navigate the complexities of pain management, these findings may influence prescribing practices and patient monitoring strategies.