Rosiglitazone and heart failure: long-term vigilance.
Thiazolidinediones have become a powerful tool for lowering insulin resistance. In many short-term clinical studies, many patients taking thiazolidinediones experience significant improvement in glycemic control and lipid profiles without any adverse effects. Health care providers should be aware that, in long-term follow-up, peripheral edema and congestive heart failure may occur in patients with multiple comorbidities more than 26 weeks after starting thiazolidinediones. This article reports two patients who developed congestive heart failure 6 to 12 months after starting rosiglitazone, in combination with insulin. The patients' glycemic control improved over the first 3 to 6 months of therapy. When edema and congestive heart failure occurred later, they recovered only after medical therapy (diuretics, afterload reduction) was titrated and the rosiglitazone was withdrawn.
Singh
Nalini
N
Department of Endocrinology and Metabolism, Veterans Affairs Puget Sound Healthcare System, Medicine-111, 1660 South Columbian Way, Seattle, WA 98108, USA. Nalini.Singh2@med.va.gov
D000368:Aged; D003920:Diabetes Mellitus / Q000188:drug therapy; D004487:Edema / Q000139:chemically induced; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000627:therapeutic use*; D013997:Time Factors
D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones; D000077154:Rosiglitazone