Final answer:
The two DM agents that may worsen heart failure outcomes are thiazolidinediones (e.g., pioglitazone and rosiglitazone) and the discontinued drug aleglitazar due to their effects on fluid retention and associated heart failure risks.
Step-by-step explanation:
Two diabetes mellitus (DM) agents that may worsen heart failure (HF) outcomes are thiazolidinediones (such as pioglitazone and rosiglitazone) and the dual peroxisome proliferator-activated receptor agonist, aleglitazar. These medications can lead to fluid retention, which exacerbates HF, and have been associated with an increased risk of HF hospitalization and cardiovascular events in some studies.
Thiazolidinediones work by increasing insulin sensitivity, but they do so at the risk of promoting fluid retention and edema, potentially worsening HF symptoms. Aleglitazar, which was investigated for its potential benefits in cardiovascular disease, was discontinued due to concerns about its safety profile, including the risk of exacerbating HF. It is important for clinicians to carefully consider the risks and benefits of these agents in patients with existing HF.
The two DM agents that may worsen HF outcomes are thiazolidinediones and the discontinued drug aleglitazar.