The Impact of Thiazolidinedione Use on Outcomes in Ambulatory Patients With Diabetes Mellitus and Heart Failure

• Published in: Journal of the American College of Cardiology 2007-07, Vol.50 (1), p.32-36
• Main Authors: Aguilar, David, MD, Bozkurt, Biykem, MD, FACC, Pritchett, Allison, MD, FACC, Petersen, Nancy J., PhD, Deswal, Anita, MD, MPH, FACC
• Format: Article
• Language: English
• Subjects: Age; Aged; Ambulatory Care; Biological and medical sciences; Body mass index; Cancer; Cardiac arrhythmia; Cardiology; Cardiology. Vascular system; Cardiovascular; Case-Control Studies; Chronic illnesses; Chronic obstructive pulmonary disease; Clinical trials; Confidence Intervals; Diabetes; Diabetes Mellitus - diagnosis; Diabetes Mellitus - drug therapy; Diabetes Mellitus - mortality; Diabetes. Impaired glucose tolerance; Disease; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Enzymes; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Heart; Heart attacks; Heart failure; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - mortality; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hospitalization; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin; Internal Medicine; Male; Medical sciences; Middle Aged; Mortality; Older people; Peer review; Pharmacy; Proportional Hazards Models; Reference Values; Retrospective Studies; Risk Assessment; Statistical analysis; Survival Analysis; Thiazolidinediones - adverse effects; Thiazolidinediones - therapeutic use; Treatment Outcome; Variables; Veterans
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.01.096

The Impact of Thiazolidinedione Use on Outcomes in Ambulatory Patients With Diabetes Mellitus and Heart Failure David Aguilar, Biykem Bozkurt, Allison Pritchett, Nancy J. Petersen, Anita Deswal Thiazolidinediones (TZDs) have been relatively contraindicated in diabetic patients with heart failure (HF) despite limited data. In a large, national cohort of patients with diabetes and HF treated in ambulatory clinics at Veterans Affairs medical centers, TZD use was not associated with an increased risk of HF hospitalization (adjusted hazard ratio 1.00, 95% confidence interval 0.81 to 1.24, p = 0.97) or total mortality (adjusted hazard ratio 0.98, 95% confidence interval 0.81 to 1.17, p = 0.80) when compared with those not receiving insulin-sensitizing medications. These data suggest that TZDs may be used safely to treat diabetes in ambulatory patients with established HF.