A mechanistic study of intravenous thiamine for acute heart failure

This study is being carried out to determine whether giving thiamine, an essential vitamin, through a drip in the arm, alters the blood level of a protein, brain natriuretic peptide (BNP). It is common for people with a diagnosis of heart failure to lack thiamine in their body, due to a number of factors including eating less, other health problems and medications, especially diuretics which are commonly referred to as ‘water tablets’. Not having enough thiamine has the potential to cause weight loss, confusion, muscle weakness and make the heart work less well. Patients who are aged 18 and over, diagnosed with heart failure, taking diuretic medicines, being admitted to hospital and able to give informed consent will be eligible to join the study. Patients will be identified in the Emergency Department or wards of the Royal Infirmary of Edinburgh. Participants will be allocated at random (like tossing a coin) into one of two groups.

One group will continue to be treated as normal and have three blood samples taken during their admission. The other group will be given a vitamin preparation called Pabrinex (which contains thiamine) during their hospital admission and also give three blood samples. Pabrinex is routinely used in hospitalised patients.

We will measure the blood concentrations of BNP and another protein, troponin, in these patients to identify the effect of thiamine.