Banner
  • Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

TZD use appears safe in ambulatory patients with diabetes and HF

Article

Thiazolidinediones (TZDs) do not appear to increase the risk of heart failure (HF) hospitalization and death in ambulatory patients with diabetes and HF, according to a retrospective analysis of a veterans population.

Thiazolidinediones (TZDs) do not appear to increase the risk of heart failure (HF) hospitalization and death in ambulatory patients with diabetes and HF, according to a retrospective analysis of a veterans population.

"I would use TZDs cautiously in patients with diabetes who have class I or II compensated HF," said the lead author of the study, David Aguilar, MD, assistant professor of medicine at Baylor College of Medicine in Houston, Texas. He noted that many clinicians are already using these agents in patients with diabetes and HF without evidence to support that this practice is safe.

TZD use is not recommended for patients with New York Heart Association class III or IV symptoms because they may exacerbate volume status and may worsen HF signs and symptoms.

Among 7,147 veterans with HF and diabetes who were treated in ambulatory clinics at Veterans Affairs medical centers, 818 were being treated with TZDs and 4,700 were not. These patients were the basis of the retrospective study, which had as its primary outcome the time to hospitalization for HF. The secondary outcome was time to death.

During 2-year follow-up, the rate of HF hospitalizations was not significantly different between the TZD users and non-users (16.4% vs. 15.8%, respectively).

The 2-year incidence of death was actually lower in the TZD users (20.5%) than the non-users (25.4%). TZD users tended to be younger with higher ejection fractions, and less likely to be hospitalized for HF in the 2 years preceding the study. When adjusting for these differences, "the benefit with TZD use went away but we still couldn't find a hazard," Dr. Aguilar said.

Although these data are reassuring, Dr. Aguilar said, he believes that a prospective, randomized trial of TZD use is warranted in patients with diabetes and class I or II symptoms.

Related Videos
Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health