4.5 Article

The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis

Journal

ACTA DIABETOLOGICA
Volume 46, Issue 2, Pages 145-154

Publisher

SPRINGER
DOI: 10.1007/s00592-008-0090-3

Keywords

Rosiglitazone; Thiazolidinediones; Coronary artery disease; Congestive heart failure; Antidiabetic agents; Hypoglycemic agents; Mortality

Funding

  1. Astra Zeneca

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Oral anti-diabetic agents have been associated with adverse cardiovascular events in type 2 diabetes (DM2). We investigated the risk of coronary artery disease (CAD), congestive heart failure (CHF), and mortality using multivariable Cox models in a retrospective cohort of 20,450 DM2 patients from our electronic health record (EHR). We observed no differences in CAD risk among the agents. Metformin was associated with a reduced risk of CHF (HR 0.76, 95% CI 0.64-0.91) and mortality (HR 0.54, 95% CI 0.46-0.64) when compared to sulfonylurea. Pioglitazone was also associated with a lower risk of mortality when compared to sulfonylurea (HR 0.59, 95% CI 0.43-0.81). No other significant differences were found between the oral agents. In conclusions, our results did not identify an increased CAD risk with rosiglitazone in clinical practice. However, the results do reinforce a possible increased risk of adverse events in DM2 patients prescribed sulfonylureas.

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