Efficacy and safety of creatine supplementation in patients with heart failure and reduced ejection fraction: a pilot study

Introduction and objectives

Heart failure (HF) poses a significant global health burden. Patients with HF experience reduced exercise tolerance, greatly affecting their quality of life. While creatine monohydrate (CM) improves functional capacity in healthy individuals, its effects in HF patients remain unexplored.

Methods

We conducted an exploratory, prospective, single center, open-label study evaluating the efficacy and safety of 5 g/day CM during 3 months in patients with HF and reduced ejection fraction. Outcomes included functional capacity, health-related quality of life (HRQoL), echocardiographic and laboratory parameters at 3-months and HF decompensations and mortality at 1-year.

Results

A total of 43 patients participated (60.73 ± 11.73 years; 30.43% females). The intervention was safe. Creatinine increased and glomerular filtration rate declined at 3 months but normalized after discontinuing CM. We observed a statistically significant increase in the 6-minute walk test (48.69 ± 32.76; P = .005), a reduction in Borg scale exertion (−1.57 ± −1.73 points; P < .01), and decreased heart rate increment during exercise (−2.43 ± −8.66 bpm; P = .04). HRQoL improved significantly (4.08 ± 12.29 points; P = .03). No changes were found in echocardiographic parameters, HF decompensations, or mortality.

Conclusions

CM supplementation in patients with HF and reduced ejection fraction is safe and could improve functional capacity and HRQoL. Further research is warranted to confirm our results.