A secondary analysis of data from the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes (RECORD) trial revealed that the risk of heart failure in patients with diabetes increases when rosiglitazone is added to standard glucose-lowering therapy with either metformin or a sulfonylurea. This study was published online in the European Heart Journal.

In this current analysis, investigators found that patients on rosiglitazone were over twice as likely to experience fatal and non-fatal heart failure events. Interestingly, treatment with rosiglitazone was not associated with an increase in the risk of cardiovascular death or hospitalization.  And, a history of cardiovascular disease was not independently associated with a risk of heart failure events.

Rosiglitazone is categorized as an insulin-sensitizing thiazolidinedione. Thiazolidinediones are known to promote water retention, and previous research has suggested that they can aggravate existing heart failure or induce new heart failure.

Analysis of the data from the RECORD trial showed a twofold increase in the risk of heart failure death or hospitalization in connection with the use of rosiglitazone. This finding provides further support for existing diabetes treatment guidelines that already recommend against the use of rosiglitazone in patients with heart failure. It also underscores the need for caution in using rosiglitazone as an add-on treatment in patients who do not have heart failure.

Source:

Eur Heart J 2010;doi: 10.1093/eurheartj/ehp604.