Diabetes medications linked to increased heart attacks risk in elderly

December 12th, 2007 - 1:18 pm ICT by admin  

Washington, Dec 12(ANI): A recent study has found that older adults when treated with a particular class of diabetes medications are at a greater risk of heart attacks and death due to congestive heart failures.

The researchers suggest that medications known as thiazolidinediones (TZDs), which include rosiglitazone, for treating type 2 diabetes has adverse cardiac effects.

While improved glycemic control has been linked to better clinical outcomes in diabetes and TZDs have been suggested as having potential cardiovascular benefits, recent concerns have arisen regarding adverse cardiac effects of these drugs, write the authors.

The study led by Lorraine L. Lipscombe, M.D., M.Sc., of the Institute for Clinical Evaluative Sciences, Toronto assessed the risks of CHF, heart attack, and all-cause death associated with the use of TZDs compared to other oral hypoglycemic agents among patients age 66 years or older with diabetes.

The researchers examined the data from health care databases in Ontario that included 159,026 individuals with diabetes who were treated with oral hypoglycemic agents

The data revealed that 7.9 percent of patients had visited the hospital for congestive heart failure, 7.9 percent visited for a heart attack, and 19 percent died.

They found that current users of TZD monotherapy had a 60 percent increased risk of congestive heart failure, 40 percent had increased risk of heart attack and 29 percent had increased risk of death.

Various researches have shown that both rosiglitazone and pioglitazone may increase the risk of congestive heart failure (CHF), and rosiglitazone may be associated with an increased risk of acute myocardial infarction (AMI; heart attack) and death.

These findings prompted U.S. Food and Drug Administration advisory panel regarding the safety of rosiglitazone, however the panel was against removing rosiglitazone from the market because of insufficient data.

Our findings argue against current labeling of TZDs that warns against use only in persons at high risk of CHF, as we did not identify any subgroup of older diabetes patients who may be protected from adverse effects of TZDs, wrote the authors.

These findings provide evidence from a real-world setting and support data from clinical trials that the harms of TZDs may outweigh their benefits, even in patients without obvious baseline cardiovascular disease, they added.

The authors said that further studies are needed to better quantify the risk-benefit tradeoffs associated with TZD therapy and to explore whether the hazards associated with these agents are specific to rosiglitazone.

The study is published in the December 12 issue of JAMA. (ANI)

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