Effect of antidiabetic drug treatment on heart failure
DOI:
https://doi.org/10.47196/diab.v56i3Sup.535Keywords:
diabetes mellitus, insuficiencia cardíacaAbstract
Diabetes mellitus (DM) is an independent risk factor for the development of heart failure (HF). The risk of developing this complication is 2 to 4 times higher in men and 5 times higher in women with diabetes. Given this scenario, it is essential to know the effect of the different pharmacological groups that we use for glycemic control on the risk of developing heart failure.
Metformin is contraindicated in patients with heart failure and glomerular filtration rate <30 ml/min due to an increased risk of developing lactic acidosis. Its use in stable patients would not increase this risk and even case-control studies showed some beneficial effect in this subpopulation although this impact was not demonstrated in randomized clinical trials. Thiazolidinediones, PPARγ agonists, such as pioglitazone and rosiglitazone are associated with an increased risk of HF hospitalizations. This risk, although it does not seem to be accompanied by an increase in mortality, is associated with an increase in the use of diuretics and hospitalizations, therefore it is contraindicated in patients with HF and should be used with caution in patients at high risk of developing HF.
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