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Avoiding Heart Risk

Feb 10, 2018

A 68-year-old male presents to your office for a follow-up visit. His past medical history is significant for a myocardial infarction (five years ago) and he has type 2 diabetes. His current medications include an ACE inhibitor, a statin, aspirin, and metformin. Despite good compliance with his medications and beneficial lifestyle changes, he is not able to achieve his individualized target A1C of 7.5-8%. You decide it would be beneficial to add a second antihyperglycemic agent. Which of the following medications should be avoided due to CVD risk?


Correct Answer: E. None of the above

Educational Critique: Cardiovascular disease is a frequent complication in patients with type 2 diabetes who have approximately 65% risk of dying of cerebrovascular or coronary artery disease. Rosiglitazone was not recommended for use as meta-analysis suggests it is associated with an increased risk of cardiovascular events. In addition, agents that can cause hypoglycemia should be used with caution as hypoglycemia can worsen myocardial ischemia and may cause arrhythmias. The FDA has removed restrictions on prescribing rosiglitazone (Avandia) after a new analysis revealed that it did not, in fact, carry a higher risk of cardiovascular events compared with other diabetes drugs, the agency announced.  


FDA Clears Avandia of MI Risk