Item #1
ACC: Retrospective Study
Indicates Glitazones Increase Risk For Heart Failure In Diabetics
Use of glitazones was associated with a 50 percent increase in
risk of heart failure, according to a retrospective study.
ATLANTA, GA -- March 19, 2002 -- A retrospective analysis of
insurance claims data suggests that use of glitazones to manage
type 2 diabetes may be associated with a significant increase in
risk for heart failure.
Thomas Delea, PhD, of Policy Analysis, Brookline, Massachusetts,
United States, presented these findings today at the American
College of Cardiology (ACC) 51st Annual Scientific
Session.
Using a database of healthcare insurance claims from 35 health
insurers, which represent up to 17 million Americans, he studied
claims filed from the period of January 1995 to March 2001. Dr.
Delea identified 8,288 diabetics who were treated with one or more
glitazone (troglitazone, rosiglitazone or pioglitazone) and 41,440
diabetic controls that didn't use glitazones. Patients who were
diagnosed with heart failure in the 12 months prior to the initial
claim for a glitazone were excluded from the study.
The initial claim for a glitazone served as the index date. He
then searched for claims indicating onset of heart failure. The
average follow-up from index date was 8.5 months. During
follow-up, the risk for heart failure was "4.5 percent among
glitazone users and 2.6 percent in non-users", Dr. Delea said at a
press briefing prior to presenting the study.
After adjusting for other potential confounders, the use of
glitazones "was still associated with a 50 percent increase in
risk of heart failure", he said.
Dr. John Buse, who heads a special committee on heart disease at
the American Diabetes Association, said glitazones are useful
medications but cautions that they need to be carefully monitored.
He said most physicians are aware that the drugs are associated
with both plasma volume expansion and edema. "The problem is that
the people who need these drugs are the people who are already at
the highest risk for heart failure."
Dr. Delea agreed and noted that in his study, glitazone users
tended to be older, had diabetic complications, received insulin
and had multiple risk factors for heart disease. "But nonetheless,
there is a consistency of effect for glitazone," he said. "And the
association between glitazone and heart failure is same across all
subgroups."
Dr. Delea did caution that the findings are based on
"observational data and need to be confirmed in a clinical trial".
====================================================
DID YOU KNOW?
Of the 16
million Americans living with diabetes today, three-fourths will
develop cardiovascular disease.
AND
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