Might not be risky to treat congestive heart failure patients with TZDs
Congestive heart failure in patients given thiazolidinediones (TZDs) might not carry the risk usually associated with congestive heart failure caused by progressive systolic or diastolic dysfunction of the left ventricle, according to a study in the Sept. 29 issue of The Lancet.
Researchers at the Lahey Clinic in Burlington, Mass., calculated pooled random-effects estimates of the risk ratios for the development of congestive heart failure in patients given TZDs compared with the control group. The main outcome measures were development of congestive heart failure and the risk of cardiovascular death.
They examined 360 of 20,191 patients who had either prediabetes or type 2 diabetes and had congestive heart failure events, 214 with TZDs and 146 with comparators. The results showed no heterogeneity of effects across the studies, which indicated a class effect for TZDs.
Compared with the control group, patients given TZDs had increased risk for development of congestive heart failure across a wide background of cardiac risk. By contrast, the risk of cardiovascular death was not increased with either of the two TZDs.
As a result, the researchers propose that congestive heart failure in patients given TZDs might not carry the risk that is usually associated with congestive heart failure caused by progressive systolic or diastolic dysfunction of the left ventricle. The researchers also suggested that longer follow-up and better characterization of such patients is needed to determine the effect of TZDs on overall cardiovascular outcome.
Researchers at the Lahey Clinic in Burlington, Mass., calculated pooled random-effects estimates of the risk ratios for the development of congestive heart failure in patients given TZDs compared with the control group. The main outcome measures were development of congestive heart failure and the risk of cardiovascular death.
They examined 360 of 20,191 patients who had either prediabetes or type 2 diabetes and had congestive heart failure events, 214 with TZDs and 146 with comparators. The results showed no heterogeneity of effects across the studies, which indicated a class effect for TZDs.
Compared with the control group, patients given TZDs had increased risk for development of congestive heart failure across a wide background of cardiac risk. By contrast, the risk of cardiovascular death was not increased with either of the two TZDs.
As a result, the researchers propose that congestive heart failure in patients given TZDs might not carry the risk that is usually associated with congestive heart failure caused by progressive systolic or diastolic dysfunction of the left ventricle. The researchers also suggested that longer follow-up and better characterization of such patients is needed to determine the effect of TZDs on overall cardiovascular outcome.