Thiazolidinedione use is not associated with worse cardiovascular outcomes: a study in 28,332 high risk patients with diabetes in routine clinical practice: brief title: thiazolidinedione use and mortality

International Journal of Cardiology
Ronan RousselP Gabriel Steg

Abstract

Assess the cardiovascular safety of Thiazolidinediones (TZD) in routine clinical practice. TZD are insulin-sensitizing antidiabetic drugs commonly used in type 2 diabetes, but their cardiovascular safety has been questioned. We examined the association between TZD use and major cardiovascular outcomes. We examined 2-year mortality, non-fatal myocardial infarction (MI), and congestive heart failure (CHF) rates among outpatients with high cardiovascular risk and diabetes according to TZD use in the REACH Registry. Multivariable adjustment and propensity scores were used in the analyses. A total of 4997 out of 28,332 patients took TZDs at baseline. During follow-up, 1532 patients died. The mortality rates (95% confidence interval [CI]) were 6.5% (5.5-7.6) with TZD and 7.2% (6.33-8.06) without; adjusted hazard ratio (HR) was 1.06 (0.89-1.26, P=0.54). The lack of association with mortality was consistent across subgroups regardless of history of atherothrombosis or CHF. Rates of non-fatal MI (HR 1.10, 95% CI 0.83-1.45, P=0.50) and non-fatal CHF (HR 0.90, CI 0.75-1.09, P=0.27) were similar in users and non-users. TZD use was associated with an increased risk of CHF in patients aged >80 years (HR 1.59, CI 1.06-2.40, P=0.03). Use of TZ...Continue Reading

References

Feb 12, 1998·Annals of Internal Medicine·D B Rubin
Jan 13, 2006·JAMA : the Journal of the American Medical Association·Deepak L BhattUNKNOWN REACH Registry Investigators
Mar 22, 2007·JAMA : the Journal of the American Medical Association·Ph Gabriel StegUNKNOWN REACH Registry Investigators
Jul 3, 2007·Journal of the American College of Cardiology·David AguilarAnita Deswal
Aug 4, 2007·Pharmacoepidemiology and Drug Safety·Charles M GerritsStuart Kupfer
Nov 29, 2007·Diabetes Care·Silvio E InzucchiDarren K McGuire
Dec 13, 2007·JAMA : the Journal of the American Medical Association·Lorraine L LipscombeDavid A Alter
Nov 26, 2008·Archives of Internal Medicine·Wolfgang C WinkelmayerDaniel H Solomon
Aug 6, 2009·Diabetologia·UNKNOWN Control GroupM Woodward
Aug 20, 2009·BMJ : British Medical Journal·David N JuurlinkMuhammad M Mamdani
Feb 2, 2010·European Heart Journal·Michel KomajdaPhilip D Home
Jun 30, 2010·JAMA : the Journal of the American Medical Association·David J GrahamJeffrey A Kelman
Aug 26, 2010·Circulation. Cardiovascular Quality and Outcomes·Debra A WertzRhonda L Bohn

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Citations

Apr 3, 2016·BMC Medical Research Methodology·David HajageYann De Rycke
Aug 18, 2017·Critical Reviews in Toxicology·Melissa A DavidsonDaniel Krewski
Oct 1, 2015·BMC Research Notes·Sandra IczkovitzJorge A Ross Terres

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