Risk of Hospitalization for Heart Failure Associated with Thiazolidinedione Therapy: A Medicaid Claims–Based Case-Control Study

Abstract

This study showed a likely association between thiazolidinedione therapy and hospitalization for heart failure within 60 days of the prescription date. A similar trend occurred with insulin therapy alone and with the combination of thiazolidinedione and insulin, but not with other oral antihyperglycemics. When thiazolidinediones are prescribed, careful consideration should be given to patients with known heart failure. In addition, all patients should be educated regarding heart failure and monitored for signs and symptoms.

Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

“…Observational data regarding the rate of heart failure with the use of SUs has been mixed, with two studies (25,26) finding an association between SU treatment and an increased rate of heart failure compared with metformin treatment, and one study (27) finding no association between SU treatment and heart failure in the context of a case-control analysis compared with no SU exposure. Beyond heart failure, the increased risk of other cardiovascular events with SU therapy is better established in clinical trials (28) and observational studies (29,30).…”

Thiazolidinediones and the risk of incident congestive heart failure among patients with type 2 diabetes mellitus

“…The effect of TZDs on the risk of CHF has also been examined in a number of observational studies . However, early observational studies had methodological limitations, including confounding by indication, the use of inappropriate comparators, and inappropriate study designs, whereas more recent studies are more informative. Of the recent studies, one involving pioglitazone was inconclusive (HR = 1.28, 95% CI = 0.85, 1.92) whereas two others found an increased risk of hospitalization for CHF .…”

Effects of Ramipril and Rosiglitazone on Cardiovascular and Renal Outcomes in People With Impaired Glucose Tolerance or Impaired Fasting Glucose

“…Such an effect has been repeatedly noted in other thiazolidinedione studies (12)(13)(14)(15)(16) and appears to be due to sodium and water retention at the renal collecting duct noted above, an increased plasma renin activity (17)(18)(19) perhaps related in part to a modest fall in blood pressure (20,21), and increased insulin action (20). Two echocardiographic studies (22,23) showed that rosiglitazone did not significantly reduce left systolic ventricular function.…”