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(Circulation. 2002;105:e9091.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

American College of Cardiology Spotlights Diabetes and Heart Resynchronization and Honors Its Own

Double Whammy of Glitazone Antidiabetics and Heart Failure Risk
Thomas Delea was quick to point out that he is not a physician when he presented the results of his retrospective-based analysis of antidiabetic drugs, called glitazones, and the risk of heart failure. As a health policy analyst at Policy Analysis Inc, in Brookline, Mass, he is concerned about the decisions physicians and insurance companies make when delivering health care.

View larger version (112K): [in this window] [in a new window]   Thomas Delea

Yet his study, which compared one person with type 2 diabetes taking glitazones to 5 controls on a different antidiabetic medication, demonstrated that 4.5% of patients taking glitazone-type medication suffered from heart failure, compared with 2.6% of those taking another medication. It is a study that could have significant effect on prescription and treatment practices. (Rezulin, Avandia, and Actos are the brand names of some typical glitazones.)

The patients using glitazones were younger and more likely to have coronary artery disease and complications of diabetes, Delea said. They also were more likely to be on insulin and taking drugs for heart disease. Their health expenses were higher than those of the controls before they started taking glitazone. The increased risk was consistent among subpopulation groups, Delea said.

"In summary, we observed consistent association between the use of glitazones and the risk of heart failure," Delea said. "It is approximately a relative risk increase of 50%. However, we advise interpreting these findings cautiously. Because of the strength of what we have observed, we advise continued research into the effects of glitazone antidiabetics on heart failure. Physicians should be vigilant . . . [Full Text of this Article]