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Thiazolidinediones were associated with higher risk of cardiovascular events in patients with type 2 diabetes and cirrhosis
- Source :
- Liver international : official journal of the International Association for the Study of the LiverREFERENCES. 41(1)
- Publication Year :
- 2020
-
Abstract
- Background& aims Type 2 diabetes mellitus (T2DM) management in patients with cirrhosis is complicated. No clinical trials have investigated appropriate antidiabetic drug use in these patients. This study compared the risks of all-cause mortality, major adverse cardiovascular events (MACE) and hepatic outcomes between patients with T2DM and cirrhosis using and not using thiazolidinedione (TZD). Methods We selected 1,705 propensity score-matched TZD users and nonusers from a Taiwan National Health Insurance Research Database cohort of T2DM patients with compensated cirrhosis between January 1, 2000, and December 31, 2012 and followed them until December 31, 2013. Cox proportional hazards models with robust sandwich standard error estimates were used to assess risks of investigated outcomes for TZD users. Results MACE incidence rates during follow-up were 2.14 and 1.30 per 100 patient-years for TZD users and nonusers, respectively (adjusted hazard ratio [aHR] 1.70; 95% confidence interval [CI], 1.32-2.19). On the basis of TZD use, the aHRs (95% CIs) for stroke, ischemic heart disease and heart failure were 1.81 (1.28-2.55), 1.59 (1.03-2.44) and 2.09 (1.22-3.60) respectively. Compared with TZD nonusers, rosiglitazone users had significantly higher aHR [1.67 (1.26-2.20)] and pioglitazone users had no significant difference of aHR [1.12 (0.90-1.64)]. All-cause mortality, hepatocellular carcinoma, decompensated cirrhosis and hepatic failure risks did not differ significantly between TZD users and nonusers. Conclusions Compared with nonuser, TZD users demonstrated significantly higher MACE risks. Therefore, the risks of cardiovascular complications should be considered when prescribing TZDs to patients with T2DM and cirrhosis.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
endocrine system diseases
Taiwan
Type 2 diabetes
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Hypoglycemic Agents
Retrospective Studies
Heart Failure
Hepatology
business.industry
Proportional hazards model
Hazard ratio
nutritional and metabolic diseases
medicine.disease
Diabetes Mellitus, Type 2
Cardiovascular Diseases
030220 oncology & carcinogenesis
Cohort
030211 gastroenterology & hepatology
Thiazolidinediones
Rosiglitazone
business
Pioglitazone
Mace
medicine.drug
Subjects
Details
- ISSN :
- 14783231
- Volume :
- 41
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Liver international : official journal of the International Association for the Study of the LiverREFERENCES
- Accession number :
- edsair.doi.dedup.....538e79aa26446512137edcf34dc793e1