Thiazolidinedione-Associated Congestive Heart Failure and Pulmonary Edema
- Asra Kermani, MD and
- Abhimanyu Garg, MD
- From the Department of Veterans Affairs Medical Center, Dallas, Tex (A.K., A.G.); and Center for Human Nutrition (A.G.), Division of Nutrition and Metabolic Diseases (A.G.), and Department of Internal Medicine (A.K., A.G.), University of Texas Southwestern Medical Center, Dallas
- Address reprint requests and correspondence to Abhimanyu Garg, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9052 (e-mail: Abhimanyu.garg{at}utsouthwestern.edu).
Abstract
• Objective: To evaluate the effect of thiazolidinediones on the development of cardiac failure and pulmonary edema during treatment of type 2 diabetes mellitus.
• Patients and Methods: We retrospectively reviewed the medical records of 6 men (aged 66 to 78 years) treated at our institution between August 1, 2001, and May 21, 2002, who had type 2 diabetes and developed signs and symptoms of congestive heart failure and pulmonary edema after 1 to 16 months of therapy with pioglitazone or rosiglitazone.
• Results: Four patients had chronic renal insufficiency; only 1 had ischemic cardiomyopathy. Symptoms resolved promptly in all 6 patients after administration of diuretics and discontinuation of the thiazolidinedione.
• Conclusion: We conclude that thiazolidinediones can cause or exacerbate heart failure and pulmonary edema and should be avoided in patients with left ventricular dysfunction or chronic renal insufficiency.
Footnotes
- © 2003 Mayo Foundation for Medical Education and Research
