Journal
DIABETES OBESITY & METABOLISM
Volume 12, Issue 12, Pages 1023-1035Publisher
WILEY
DOI: 10.1111/j.1463-1326.2010.01262.x
Keywords
cardiovascular disease; myocardial infarction; pioglitazone; rosiglitazone; thiazolidinediones
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Meta-analyses of clinical trials suggest that the use of the thiazolidinedione (TZD), rosiglitazone, in patients with type 2 diabetes mellitus may increase the risk of myocardial ischaemic events by 30-40%. Although these controversial data must be interpreted with caution, in the absence of definitive prospective cardiovascular (CV) outcomes data, they represent a prominent source of evidence concerning the CV safety of rosiglitazone. The results of meta-analyses and a large randomized-controlled CV outcomes trial provide strong evidence that pioglitazone does not increase the risk of coronary events. This article clarifies the clinical significance of these meta-analytical findings alongside other sources of evidence and assesses their impact on evolving treatment guidelines and recommendations for the use of TZDs in patients with type 2 diabetes.
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