综述文章：噻唑烷二酮类药物与心力衰竭。

Review article: Thiazolidinediones and heart failure.

机构信息

The Northwest Heart and Transplant Centre, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom.

出版信息

Diab Vasc Dis Res. 2009 Jul;6(3):146-52. doi: 10.1177/1479164109338772.

PMID:20368206

Abstract

DM is an independent risk factor for the development of HF and its presence confers an adverse prognosis for those already diagnosed with HF.TZDs are potent insulin-sensitisers associated with a number of beneficial cardiovascular effects. However,TZDs increase renal sodium and water reabsorption, leading to fluid retention and overt signs of HF in patients with diabetes. Rosiglitazone has also been associated with an increased risk of myocardial infarction and cardiovascular mortality. However, pioglitazone may have macrovascular benefits. The majority of data on the cardiovascular safety of TZDs are based on non-cardovascular outcome trials and meta-analyses. Concerns regarding the risk of HF and cardiovascular safety of TZDs have led to restrictions on their use in patients with HF. This review addresses the latest evidence for HF with each of the TZD drugs currently available and reflects on the current guidelines regarding their prescription in at-risk patients.

摘要

DM 是 HF 发展的独立危险因素，其存在预示着 HF 患者预后不良。TZDs 是强有力的胰岛素增敏剂，与多种有益的心血管作用相关。然而，TZDs 增加肾脏钠和水的重吸收，导致糖尿病患者液体潴留和 HF 的明显体征。罗格列酮也与心肌梗死和心血管死亡率增加相关。然而，吡格列酮可能具有大血管益处。TZDs 的心血管安全性的大多数数据基于非心血管结局试验和荟萃分析。对 HF 风险和 TZDs 心血管安全性的担忧导致限制了其在 HF 患者中的应用。本综述针对目前可用的每种 TZD 药物的 HF 最新证据进行了讨论，并对高危患者处方 TZD 的当前指南进行了反思。