'Risky' Diabetes Drugs May Help Heart Failure
Despite Warnings, Diabetes Drugs May Lower Death Rate in People With Heart Failure
In this study, researchers followed 16,417 Medicare patients with diabetes who were discharged from the hospital after treatment for heart failure.
Researchers divided the patients into groups based on their diabetes treatments and then compared the rates of death and readmission to the hospital.
After one year of follow-up, the study showed that the risk of death from all causes was about 13% lower among the 2,226 patients who received thiazolidinediones or metformin, compared with patients who received neither drug.
Researchers found a small 6% increase in the risk of readmission to the hospital for heart failure among those taking a thiazolidinediones, which researchers say may be a reflection of these drugs' propensity to cause fluid retention. The risk of hospitalization for heart failure was 8% lower among those treated with metformin.
However, there was no difference in hospital admission rates for any cause between those who received the "risky" drugs and those who didn't.
The results appear in the Feb. 8 issue of Circulation: Journal of the American Heart Association.
"The study highlights that there may be significant benefits of these drugs in patients with diabetes and heart failure, but we wouldn't advocate practicing outside current recommendations for use of these medications, says Masoudi. "It is a call for randomized trials in populations such as this, which are at very high risk for adverse outcomes from diabetes and from heart failure."
The study also emphasizes the importance of closely monitoring patients on thiazolidinediones.
Robert Rizza, MD, president-elect of the American Diabetes Association, agrees.
"These are provocative data that further supports the need for additional data from the ongoing randomized studies to determine whether these drugs are of value or not," says Rizza.
"These drugs have various actions, some of which may be helpful to people with heart disease, and others which may be harmful to people with heart disease," says Rizza, who is also professor of medicine at the Mayo Clinic College of Medicine in the division of endocrinology, diabetes, nutrition, and metabolism.
"When looking at population-based studies you cannot determine cause from effect, and it's not clear that there was improved survival because the people who had potentially worse outcomes were not placed on the drug because people were concerned about the action of the drug," says Rizza. "That's why additional studies are needed."
'Risky' Diabetes Drugs May Help Heart Failure
Despite Warnings, Diabetes Drugs May Lower Death Rate in People With Heart Failure
Should High-Risk Patients Take the Diabetes Drugs? continued...
In this study, researchers followed 16,417 Medicare patients with diabetes who were discharged from the hospital after treatment for heart failure.
Researchers divided the patients into groups based on their diabetes treatments and then compared the rates of death and readmission to the hospital.
After one year of follow-up, the study showed that the risk of death from all causes was about 13% lower among the 2,226 patients who received thiazolidinediones or metformin, compared with patients who received neither drug.
Researchers found a small 6% increase in the risk of readmission to the hospital for heart failure among those taking a thiazolidinediones, which researchers say may be a reflection of these drugs' propensity to cause fluid retention. The risk of hospitalization for heart failure was 8% lower among those treated with metformin.
However, there was no difference in hospital admission rates for any cause between those who received the "risky" drugs and those who didn't.
The results appear in the Feb. 8 issue of Circulation: Journal of the American Heart Association.
Too Soon to Change Recommendations
"The study highlights that there may be significant benefits of these drugs in patients with diabetes and heart failure, but we wouldn't advocate practicing outside current recommendations for use of these medications, says Masoudi. "It is a call for randomized trials in populations such as this, which are at very high risk for adverse outcomes from diabetes and from heart failure."
The study also emphasizes the importance of closely monitoring patients on thiazolidinediones.
Robert Rizza, MD, president-elect of the American Diabetes Association, agrees.
"These are provocative data that further supports the need for additional data from the ongoing randomized studies to determine whether these drugs are of value or not," says Rizza.
"These drugs have various actions, some of which may be helpful to people with heart disease, and others which may be harmful to people with heart disease," says Rizza, who is also professor of medicine at the Mayo Clinic College of Medicine in the division of endocrinology, diabetes, nutrition, and metabolism.
"When looking at population-based studies you cannot determine cause from effect, and it's not clear that there was improved survival because the people who had potentially worse outcomes were not placed on the drug because people were concerned about the action of the drug," says Rizza. "That's why additional studies are needed."
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