Most Read Articles
Rachel Soon, 26 Jun 2018

MIMS Pharmacist presents an overview of phosphatidylcholine's physiological role, as well as contemporary research on its pharmacology and effects.

Tristan Manalac, 16 Dec 2017
Methylphenidates, but not amphetamines, when taken during the first trimester of pregnancy, slightly increase the risk of cardiac congenital malformations, a recent study has shown.
Saras Ramiya, 12 Aug 2016
Patient-centred care is the focus of the upcoming International World Pharmacists' Day Convention, which is coorganized by the Malaysian Community Pharmacy Guild (MCPG) and the Malaysian Pharmaceutical Society (MPS) in September.
Pearl Toh, Yesterday
The survival benefits conferred by blood pressure (BP) and lipid-lowering medications persist even after more than a decade following the end of the original trial, according to results from the ASCOT* Legacy study.

Thiazolidinediones do not lower AF incidence in patients with diabetes, coronary disease

12 Jul 2018
Studies have shown that in general, about 40% of patients are non-adherent to their medication.

Use of thiazolidinediones does not lead to a significant reduction in incidence of atrial fibrillation (AF) among patients with diabetes and coronary disease, a recent study has found.

Of the 2,319 patients enrolled in the study, 1,160 were assigned to the insulin-sensitization strategy and 1,159 to the insulin-provision strategy. A total of 90 patients (3.9 percent) developed new-onset AF during a median follow-up of 4.2 years.

The intention-to-treat analysis demonstrated an AF incidence of 8.7 per 1,000 person-years in patients assigned to insulin sensitization vs 9.5 in those assigned to insulin provision (hazard ratio [HR], 0.91; 95 percent CI, 0.60–1.38; p=0.66).

On the other hand, the incidence rate per 1,000 person-years in a time-varying exposure analysis was 7.2 for patients exposed to thiazolidinediones and 9.7 for those who were not (adjusted HR, 0.80; 0.33–1.94; p=0.62). The HR in a subset of patients matched on propensity to receive thiazolidinediones was 0.75 (0.43–1.30; p=0.30).

A 2008 study showed that the glycaemic efficacy of thiazolidinediones and metformin were similar, but adverse effects and higher costs made the former less appealing for initial therapy. [Ann Pharmacother 2008;42:1466-1474]

To examine whether insulin-sensitizing therapy (thiazolidinediones or metformin) reduced the risk of developing AF vs insulin-providing therapy (insulin, sulphonylurea or meglitinide), the authors enrolled patients with type 2 diabetes and documented coronary artery disease. All patients were randomly assigned to insulin-sensitizing or insulin-providing therapy.

“Thiazolidinediones are insulin sensitizers that also decrease the inflammatory response,” the authors said. “Because inflammation is a risk factor for AF, we hypothesized that treating diabetes with thiazolidinediones might decrease the risk of developing AF.”

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Most Read Articles
Rachel Soon, 26 Jun 2018

MIMS Pharmacist presents an overview of phosphatidylcholine's physiological role, as well as contemporary research on its pharmacology and effects.

Tristan Manalac, 16 Dec 2017
Methylphenidates, but not amphetamines, when taken during the first trimester of pregnancy, slightly increase the risk of cardiac congenital malformations, a recent study has shown.
Saras Ramiya, 12 Aug 2016
Patient-centred care is the focus of the upcoming International World Pharmacists' Day Convention, which is coorganized by the Malaysian Community Pharmacy Guild (MCPG) and the Malaysian Pharmaceutical Society (MPS) in September.
Pearl Toh, Yesterday
The survival benefits conferred by blood pressure (BP) and lipid-lowering medications persist even after more than a decade following the end of the original trial, according to results from the ASCOT* Legacy study.