Furosemide may increase the risk of fractures in children with CHD

Researchers analyzed the effect of furosemide on bone fractures in children with ischemic heart disease

The use of furosemide in children with congenital heart disease (CHD) may increase the risk of bone fracture in these patients, according to the findings presented at the ACC.17 Scientific Session.

Patients with CHD are often prescribed furosemide, loop diuretic, which is associated with loss of bone mineral density. To determine the effect of furosemide treatment on the incidence of bone fractures in children with coronary artery disease, researchers extracted data from the Texas Medicaid databases.

To be included in the study, children should have been diagnosed with CHD, cardiomyopathy or heart failure and be less than 12 years old. Then the patients were divided into three groups: furosemide-adherent (ratio of possession of the drug more than 70%) (n = 254), furosemide non-adherent (ratio of possession less than 70%) (n = 724) and no furosemide (n = 2,934). For comparison of the three groups, logistic regression and the Cox proportional hazard model with the Kaplan-Mayer graph were used.

It was found that in the furosemide-adherent group, the highest fracture rate was 9.06%, followed by a non-adherent group of furosemide (7.18%), and finally, the no furosemide group (5.04%). Compared to the absence of furosemide, both furosemide groups were more likely to have fractures, using logistic regression (odds ratio for furosemide-adherent group [OR] 1.87, 95% CI: 1.17-2.98, P = 0.009; furosemide-non-adherent group [OR] 1.53, 95% CI: 1.10-2.14, P = 0.011). In addition, compared to the absence of a furosemide group, the risk of fractures in the furosemide-adherent group was significantly higher (HR 1.56, 95% CI: 1.01-2.42, P = 0.049).

“Clinicians who treat patients with heart disease should be aware of the increased risk of fractures and bone disease screening in this group of patients,” the authors concluded.