Use of Thiazolidinediones and Risk of Heart Failure in People With Type 2 Diabetes

• DOI: 10.2337/diacare.26.11.2983
• Publication Date: 2007-03-05T22:51:27Z
• Authors: Thomas E. Delea; John S. Edelsberg; May Hagiwara; Gerry Oster; Lawrence S. Phillips
• Keywords: Heart Failure; Insurance, Health; Incidence; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Diabetes Mellitus, Type 2; Risk Factors; Thiazolidinediones; Proportional Hazards Models; Retrospective Studies

OBJECTIVE—To compare the incidence of heart failure in individuals with type 2 diabetes receiving thiazolidinediones (TZDs) versus other oral antihyperglycemic agents. RESEARCH DESIGN AND METHODS—We conducted a retrospective cohort study using health insurance claims database. The sample included patients who received an agent between January 1995 and March 2001. Those any for TZDs were designated “exposed,” each was compared five randomly selected unexposed patients. diagnoses or digoxin diuretic year before their index date excluded. primary measure interest failure, which defined as hospitalization outpatient visit diagnosis failure. RESULTS—TZD (n = 5,441) younger than control subjects 28,103) but more likely to have coronary artery disease complications, receive ACE inhibitors, β-blockers, metformin, insulin, undergone HbA1c tests eye exams; they also had comorbidities higher costs (all P < 0.05). However, TZD use predictive even after controlling these variables (hazard ratio 1.7, 0.001). Adjusted at 40 months 8.2% 5.3% subjects. CONCLUSIONS—The results this observational suggest that may increase risk Physicians should caution remain vigilant manifestations those drugs (especially cardiovasculopathy), consider alternate therapies develop symptoms such shortness breath.