Association of thiamine administration and prognosis in critically ill patients with heart failure

Abstract

Background: Thiamine deficiency is common in patients with heart failure, and thiamine supplement can benefit these patients. However, the association between thiamine administration and prognosis among critically ill patients with heart failure remains unclear. Thus, this study aims to prove the survival benefit of thiamine use in critically ill patients with heart failure.Methods: A retrospective cohort analysis was performed on the basis of the Medical Information Mart of Intensive Care-Ⅳ database. Critically ill patients with heart failure were divided into the thiamine and non-thiamine groups depending on whether they had received thiamine therapy or not during hospitalization. The association between thiamine supplement and in-hospital mortality was assessed by using the Kaplan−Meier (KM) method and Cox proportional hazard models. A 1:1 nearest propensity-score matching (PSM) and propensity score-based inverse probability of treatment weighting (IPW) were also performed to ensure the robustness of the findings.Results: A total of 7,021 patients were included in this study, with 685 and 6,336 in the thiamine and non-thiamine groups, respectively. The kaplan−meier survival curves indicated that the thiamine group had a lower in-hospital mortality than the none-thiamine group. After adjusting for various confounders, the Cox regression models showed significant beneficial effects of thiamine administration on in-hospital mortality among critically ill patients with heart failure with a hazard ratio of 0.78 (95% confidence interval: 0.67–0.89) in the fully adjusted model. propensity-score matching and probability of treatment weighting analyses also achieved consistent results.Conclusion: Thiamine supplement is associated with a decreased risk of in-hospital mortality in critically ill patients with heart failure who are admitted to the ICU. Further multicenter and well-designed randomized controlled trials with large sample sizes are necessary to validate this finding.

Role of Thiamine Supplementation in the Treatment of Chronic Heart Failure: An Updated Meta‐Analysis of Randomized Controlled Trials

“…In addition, correcting TD may confer benefits in terms of preventing further cardiac function deterioration and reducing the incidence of other complications in patients with CHF. For example, a recent study demonstrated that thiamine supplementation significantly decreased in‐hospital mortality rates among severe HF patients admitted to the intensive care unit [ 30 ].…”

Thiamine administration may increase survival benefit in critically ill patients with myocardial infarction

“…A meta-analysis summarizing data from two randomized controlled trials has shown that thiamine supplementation induces an overall improvement in left ventricular ejection fraction (LVEF) by 3.28% among patients with systolic heart failure ( 31 ). Yang et al indicated that the probability of in-hospital death in patients with heart failure is dramatically reduced by 26% when thiamine supplementation is used ( 8 ). Additionally, Schoenenberger et al demonstrated an improvement in LVEF among patients with heart failure who have received 300 mg/day thiamine supplementation for 4 weeks ( 32 ).…”

“…Micronutrient deficiency may reduce energy generation in cardiomyocytes and lead to poor clinical outcomes in patients with CVD ( 8 ). Thiamine, also known as vitamin B1, is an essential water-soluble vitamin that cannot be synthesized by the human body.…”