Riluzole Mitigates The Risk Of Heart Failure Admissions

• Published in: Journal of cardiac failure Vol. 30; no. 1; p. 164
• Main Authors: Kim, Kibum, Kim, Sodam, Katana, Margaret, Radwanski, Przemyslaw, Munger, Mark A.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2024
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2023.10.115

Targeting intracellular sodium accumulation through the late Na+ current modulates cardiac calcium handling, which underlies myocardial contractility and relaxation in heart failure (HF). This modulation has been recognized as a potential new early strategy in maintaining neurohormonal balance to evade acute heart failure (AHF). Riluzole (R) is an agent for management of amyotrophic lateral sclerosis (ALS). It promotes neuronal-type Na+ channel blockade and enhances Ca2+-activated K+ channel function. The goal of this investigation was to test whether R prevents AHF admissions. Rates of AHF admission were compared using a commercial insurance and Medicare supplement claims database. Patients who filled a prescription for R (treatment) or had an ALS encounter between June 2009 to December 2019 were compared to no-R (control). Time to admission with a 1°, 2° or 3° AHF diagnosis from the index R prescription or ALS date were analyzed using a Kaplan-Meier approach. Rate of AHF admissions were compared using multivariable Cox proportional hazard regression model where potential confounders were adjusted. The study cohort consisted of 4,411 R and 6,937 no-R ALS patients with a mean age (SD) of 59.1±12.7 vs. 62.3±14.7 and 55.7% vs. 58.5% male. The cumulative ADF admission for R vs. no-R ALS were 0.39% vs. 2.01% at 730 days; hazard ratio (HR) [95% CI, p-value] of 0.248 [0.105 - 0.583, p<0.01]. (Figure) The measure of association showed the protective effect of R after adjusting for the Medicare enrollment and baseline HF status. However, the small number of events (i.e., 6 vs. 42 HF-admission from R vs. no-R ALS patients, respectively), the adjusted HR was marginally significant with the estimate of 0.420 [0.175 - 1.010, p=0.053]. R mitigates admission rates suggesting a potential new early research strategy for preventing AHF.