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Pepcid May Slow Progression of Chronic Heart Failure

October 3, 2006

Non-prescription stomach medication Pepcid (famotidine) may offer protection against the progressively debilitating effects of chronic heart failure (CHF), according to a new study.

Research conducted by the National Cardiovascular Center, in Suitra, Japan, suggests that the chemical reaction in which stomach acid causes heartburn and ulcer-formation may also cause damage to diseased hearts. Using Pepcid may help to block this reaction and thereby slow CHF’s progression.

Lead researcher Masafumi Kitakaze, MD, PhD, director of the Cardiovascular Division and vice president of the Research and Clinical Center at the National Cardiovascular Center, and colleagues published their study results in the October 3rd edition of the Journal of the American College of Cardiology.

Heart failure affects an estimated 23 million people worldwide. In people affected by CHF, occurs when the heart is unable to pump as effectively as it should, resulting in shortness of breath, swelling in the legs and ankles, and other health issues.

Should People with CHF Take Pepcid?

Both the study’s researchers and other doctors note that more research is required before famotidine is prescribed fro people with CHF.

"We performed the present prospective study with only 50 CHF patients," said Dr Kitakaze. "Now we need to conduct a large-scale trial to confirm the present findings. The large-scale trial based on the results our present research may not help current heart failure patients because it takes time, but we hope it helps our children and grandchildren and others in the future."

Gary Francis, MD, head of the Section of Clinical Cardiology at Cleveland Clinic, believes that famotidine’s potential benefits for people with CHF patients require more investigation.

"At this point, we don’t know whether it would help," said Dr Francis, who co-wrote an editorial on treating CHF that was published in the same journal issue. "In addition, there is an expense involved, and we’re not certain what the dose should be or what the safety would be of larger doses if they were necessary. I certainly would not recommend that patients go out and start taking Pepcid three times a day or anything like that."

Dr Francis noted that the new findings are significant because they open up new possibilities for treating CHF.

Clinical Trial

Dr Kitakaze and colleagues speculated that blocking the effects of a histamine released by damaged heart cells might slow the progression of heart failure. This histamine also helps to cause stomach ulcers and chronic heartburn.

Famotidine (Pepcid) acts as a histamine blocker, interfering with the histamine’s ability to bind to its receptor and subsequently cause the associated health problems.

The researchers first conducted a retrospective review of data: they examined medical records of patients receiving treatment for both CHF and gastroesophageal reflux disease (GERD). Indeed, qualifying patients who were taking famotidine for stomach problems appeared also to have less severe CHF symptoms, compared with patients using other topes of stomach medications.

Next, they conducted a prospective clinical trial to directly test the theory that heart-health may be linked with stomach medication.

A total of 25 patients (with both CHF and GERD) received famotidine (30 mg daily), while another 25 patients received teprenone (a stomach medication that works by making the stomach secrete a thicker coat of protective mucous.)

The results at 24 weeks showed that the patients receiving famotidine displayed less severe CHF symptoms, as determined by three independent cardiologists who examined the patients and were not informed of the treatment protocols.

Progression Of Chronic Heart Failure May Be Slowed By Heartburn Drug, Medical News Today, September 27, 2006.
Impact of Blockade of Histamine H2 Receptors on Chronic Heart Failure Revealed by Retrospective and Prospective Randomized Studies. Jiyoong Kim et al, Journal of the American College of Cardiology, volume 48, pages 1378-1384, published online September 12, 2006.
Histamine, Mast Cells, and Heart Failure: Is There a Connection? G Francis and WHW Tang, Journal of the American College of Cardiology, volume 48, pages 1385-1386, published online September 12, 2006.

Posted: October 2006