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The thiazolidinediones (TZDs) rosiglitazone and pioglitazone are known to increase fluid retention and congestive heart failure. Concern about the cardiovascular safety of these drugs has risen since May 2007, when results of a meta-analysis indicated that patients randomized to rosiglitazone had significantly increased risk for myocardial infarction (Journal Watch May 24 2007).
In a new meta-analysis, researchers reviewed seven randomized trials involving 20,191 patients with type 2 diabetes or prediabetes who were randomized to a TZD or a comparator drug or placebo for 12 to 48 months and were studied for outcomes including CHF and cardiovascular death. Patients who received a TZD had significantly increased risk for CHF compared with cont…