在糖尿病的老年患者中, thiazolidinediones 和心血管结果
相关实验视频
Lorraine L Lipscombe1, Tara Gomes, Linda E Lévesque
1Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. lorraine.lipscombe@ices.on.ca
JAMA
|December 13, 2007
概括
在2型糖尿病的老年人中使用 thiazolidinedione (TZD) 会增加心力衰竭,心脏病发作和死亡的风险. 与其他糖尿病药物相比,这些风险主要与罗西格利塔有关.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 铁二 (TZDs) 用于治疗2型糖尿病.
- 以前的研究表明,TZD可能会增加充血性心力衰竭和心肌梗塞的风险.
- 关于TZD心血管风险的人口级数据有限.
研究的目的:
- 调查 thiazolidinedione (TZD) 治疗与心血管事件之间的关联.
- 为了比较TZD使用者和其他口服低血糖药物使用者之间的充血性心力衰竭,急性心肌梗塞和死亡率的风险.
主要方法:
- 使用安大略省医疗保健数据库进行回顾性队列研究.
- 包括159,026名66岁以上的2型糖尿病患者,接受口服低血糖药物治疗 (2002-2005).
- 嵌套病例控制分析,比较TZD (罗西格利塔,皮奥格利塔) 单疗法与其他口服低血糖剂组合,随访至2006年3月31日.
主要成果:
- 与其他口服药物相比,在平均3.8年内,TZD单疗显示出严重增加的充血性心力衰竭 (RR 1.60),急性心肌梗塞 (RR 1.40) 和全因死亡率 (RR 1.29) 的风险.
- 这些高风险主要与罗西格利塔使用有关.
- 这项研究确定了12491例充血性心力衰竭,12578例急性心肌梗塞和30265例死亡病例.
结论:
- 在老年糖尿病患者中, thiazolidinedione 治疗,特别是罗西格利塔,与充血性心力衰竭,急性心肌梗塞和死亡率的风险更高有关.
- 研究结果表明,要仔细考虑在这个人群中使用TZD.
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