No difference in blood thiamine diphosphate levels between Swedish Caucasian patients with congestive heart failure treated with furosemide and patients without heart failure

Abstract

. Yue Q‐Y, Beermann B, Lindstrom B, Nyquist 0 (Huddinge University Hospital, Huddinge, and the Medical Product Agency, Uppsala, Sweden). No difference in blood thiamine diphosphate levels between Swedish Caucasian patients with congestive heart failure treated with furosemide and patients without heart failure. Intern Med 1997; 242:49 1‐49 5. Objectives: To determine whether furosemide treatment in congestive heart failure (CHF) patients is associated with thiamine deficiency. Design: Patients without heart failure and without diuretic treatment were included to compare with patients with CHF belonging to New York Heart Association (NYHA) functional class I1 and 111‐IV, respectively, and receiving furosemide therapy. Setting: All patients were recruited from the emergency ward of the cardiology section, Huddinge University Hospital, where they were admitted due to CHF or acute myocardial infarction. Subjects: Ninety‐nine patients were included from whom a blood sample was taken, as well as routine admission blood samples for the analysis of thiamine diphosphate (TPP) concentrations: Patients taking vitamin preparations were excluded. Main outcome measures: Blood TPP concentrations were measured by high performance liquid chromatography (HPLC) and compared between the patient groups by the use of ANOVA. Results: No significant difference was found between the groups in blood TPP concentrations. Conclusions: Thiamine deficiency may not be a complication of furosemide treatment in the studied Swedish patient population.

Diuretic Medication Therapy Use and Low Thiamin Intake in Homebound Older Adults

“…This scenario suggests that a diet that meets the nutritional needs of persons not using diuretic therapy may not meet the needs of diuretic users. More importantly, studies have suggested previously that thiamin deficiency may not be common among diuretic users if the users are consuming a reasonable diet and thus can tolerate the negative impact of diuretics on thiamin metabolism (Hardig, Daae, Dellborg, Kontny, & Bohmer, 2000;Shimon, Almog, Vered et al, 1995;Yue, Beermann, Lindstrom, & Dyquist, 1997). The data presented here, however, demonstrate that dietary thiamin intake is not always adequate despite regular receipt of home-delivered meals among homebound older adults.…”

The Prevalence of Thiamin Deficiency in Hospitalized Patients With Congestive Heart Failure

“…Numerous factors have been reported to increase the risk of developing TD in CHF patients, including diureticinduced urine thiamin excretion (2)(3)(4)(5), severe heart failure (6), malnutrition (6,7), advanced age, and frequent hospitalizations (5,8 -12). The prevalence of TD in CHF patients has been reported to range from 3% to 91% (2,(5)(6)(7)12,13 ). Trials of thiamin supplementation, although clinically important, have been hampered by their small sample sizes, use of indirect measures of thiamin status, and exclusion of patients with less severe disease and those on diuretics other than loop diuretics (2,8,(11)(12)(13)(14)(15)(16)(17).…”

“…The prevalence of TD in CHF patients has been reported to range from 3% to 91% (2,(5)(6)(7)12,13 ). Trials of thiamin supplementation, although clinically important, have been hampered by their small sample sizes, use of indirect measures of thiamin status, and exclusion of patients with less severe disease and those on diuretics other than loop diuretics (2,8,(11)(12)(13)(14)(15)(16)(17). Therefore, the objective of this study was to determine the prevalence of TD in a large cross section of hospitalized CHF patients.…”

The management of conditioned nutritional requirements in heart failure

“…In patients with heart failure, the reported incidence of thiamine deficiency ranges from 13% to 93% [14][15][16][17][18][19]. There are numerous factors that have been found to be associated with thiamine deficiency in patients with heart failure including loop diuretic use [14,15], malnutrition [16,17], severe heart failure [16], advanced age and frequent hospitalizations [15,18,20,21].…”