Incidence cardiovascular events in diabetes patients used thiazolidinediones

Abstract

               Background : Rosiglitazone and pioglitazone,belong to the class called thiazolidinediones.Trosiglitazone,the first agent of this class to be approved was effective in controlling glycemia but was removed from the market because of serious liver toxicity.Both thiazolidinediones
are effective at lowering glycosylated haemoglobin (HbA1C) when used as monotherapy or in combination. European Medicine Agency (EMEA) on the 23rdseptember 2010 removed rosiglitazone ’s marketing authourisation across Europe because of rosiglitazone increases the risk of myocardial infarction in patients type2 diabetes mellitus. Pioglitazone is increased fluid retention and reported heart failure. Pioglitazone is still available for use in selected patients ,butsuch patients should have
their heart failure risk assessed before they are prescribed it.Objective : To determine the incidence of MI,new–onset angina, CHF ,Stroke in Type2 diabetic patients used pioglitazone, side effect of pioglitazone and risk factor of cardiovascular events during use pioglitazone.Methods : Retrospective study of 389 diabetes patients used thiazolidinedionesat sichon hospital from 1 January 2014- 31
December 2014 were included.Personal history and medical history were collected. Cardiovascular events (AMI,new angina ,CHF,Stroke) were collected. Adverse side effect of pioglitazone (weight gain,
edema,hypoglycemia) were collected.This analysis evaluated the risk factor of cardiovascular events in diabetes patients during use pioglitazone Results : 26diabetes patients (6.7%) used thiazolidinedione
(pioglitazone) had cardiovascular events during the study.Incidence of cardiovascular events were AMI (7 diabetes patients,1.8%), angina (1diabetes patient,0.3%) CHF (16 diabetes patients,4.1%) and stroke
(5 diabetes patients,1.3%). Side effect of pioglitazone were weight gain (233 diabetes patients,59.9%),edema (72 diabetes patients,18.5%) and hypoglycemia (36 diabetes patients,9.3%).Risk factor of cardiovascular events (sex,age, dose of pioglitazone , duration of treatment and
weight gain) were not associated with cardiovascular events. Discussion :Pioglitazone is the only remaining TZD licensed for use in the treatment of type2 diabetes. It can offer effective and
durable glycaemic control .It may have a use in selected patients, but care should be taken in assessing suitable patients as it is associated cardiovascular events(AMI,angina,CHF,stroke).Conclusions : Incidence of cardiovascular events in diabetes patients during use pioglitazone were 6.7%. Incidence cardiovascular events were AMI (1.8%), angina (0.3%), CHF (4.1%) and stroke (1.3%).Risk factor of cardiovascular events (sex,age,dose of pioglitazone,duration of treatment and weight gain) were not associated with cardiovascular events.