Risk of cardiovascular disease and all-cause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: a meta-analysis of retrospective cohort studies
ABSTRACT The difference of cardiovascular effects between rosiglitazone and pioglitazone treatment for diabetic patients has not been thoroughly studied. We performed a meta-analysis to compare the risk of cardiovascular adverse effects in patients with type 2 diabetes treated with rosiglitazone compared to pioglitazone.
The Cochrane Library, PubMed, and Embase were searched to identify retrospective cohort studies assessing cardiovascular outcomes with rosiglitazone and pioglitazone. Meta-analysis of retrospective cohort studies was conducted using RevMan 5.0 software to calculate risk ratios.
Of the 74 references identified, eight studies involving 945 286 patients fit the inclusion criteria for the analysis. The results of meta-analyses showed that, compared with pioglitazone, rosiglitazone therapy significantly increased the risk of myocardial infarction (risk ratios (RR) 1.17, 95% confidence interval (CI) 1.04 - 1.32; P = 0.01), the risk of heart failure (RR 1.18, 95%CI 1.02 - 1.36; P = 0.03), and total mortality (RR 1.13, 95%CI 1.08 - 1.20; P < 0.000 01).
Compared with pioglitazone, rosiglitazone was associated with an increased risk of myocardial infarction, heart failure, and all-cause mortality in diabetic patients.
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- "This increases the likelihood of furring up of the vessels (atherosclerosis) what causes a narrowing of the artery, reduces the blood flow and increases blood pressure. Moreover, people with T2DM also often have low HDL cholesterol and raised triglyceride levels, which both increase the risk of CVD   . Besides, high blood pressure, smoking, obesity and lack of physical activity are also risk factors for CVD   . "
ABSTRACT: Animal models of diabetes coupled with proteome profiling have great potential not only to provide important insights to the mechanisms of the development of diabetes, its complications, but also help to identify new protein potential candidate biomarkers and to support for therapy of the disease. The aim of this study is to profile thermostable proteins in diabetic cardiovascular rat plasma. Diabetic cardiovascular rats were induced by high-fat diet and low-dose streptozotocin (STZ) injection. Diabetic cardiovascular rat plasma has been used for thermostable pre-fractionation. The thermostable proteins have been separated and identified by using two-dimensional electrophoresis and nanoLC-MS/MS. At least five proteins (fibrinogen alpha chain, antithrombin-III precursor, angiotensinogen 1, haptoglobin, haptoglobin alpha 1S) were significantly up-regulated and three proteins (apolipoprotein A-IV, apolipoprotein E, apolipoprotein A-I) were down-regulated in diabetic cardiovascular samples, in which, the concentration of the antithrombin-III increased most (2.87 folds), followed by fibrinogen alpha chain (2.02 folds), angiotensinogen 1 (1.42 folds), haptoglobin (1.97 folds), haptoglobin alpha 1S (1.59 folds), while apolipoprotein A-I decreased 1.37 folds, apolipoprotein A-IV and apolipoprotein E were not detected in diabetic cardiovascular rat’s plasma, as compared with that of the control rats. The different expression level of thermostable proteins in STZ rat plasma could give us new and important evidence for the understanding of the mechanism of diabetic cardiovascular diseases02/2014; 4(1):9-14. DOI:10.5963/LSMR0401002
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- "An obvious relationship between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CDV) has been shown . A meta-analysis of retrospective cohort studies on the risk of cardiovascular adverse effects in patients with type 2 diabetes treated with p ioglitazone co mpared to rosiglitazone has indicated that the later was associated with an increased risk o f myocardial infarct ion, heart failure, and all-cause mortality in diabetic patients. Diab etic co mp lications have been alread y kno wn , includ ing in creased th ickness o f the int ima of tho racic aorta, card iac autonomic neuropathy, foot ulcers, and ch ron ic kidney d isease. "
ABSTRACT: ptozotocin injection in rats model during 24 weeks was characterized by the increasing their growth rate/body weight, histological changes in the kidney, aorta and biochemical parameters. It was shown that all of the high-fat diet plus STZ injection rats exhibited remarkable lesions and plaque in their aorta representing damage to large blood vessels. Rats suffered from hyperglycemia in whole studying duration exhibited global glomerulosclerosis, hyaline arteriosclerosis and glomerular nodule, which are comparable with characteristics observed in late stage of human nephropathy. The rest diabetic rats demonstrated features of mild nephropathy corresponding with an early stage of kidney disease. The profiling of biochemical parameters indicated that blood glucose, lipids, HbA1c and urine microalbumin were much higher in high-fat diet plus STZ injection rats than that in controlsInternational Journal of Experimental Diabetes Research 01/2013; 2(3):50-55.
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ABSTRACT: The prevalence of obesity has increased worldwide and is a source of concern since the negative consequences of obesity start as early as in childhood. The most commonly used anthropometric tool to assess relative weight and classify obesity is the body mass index (BMI); BMI alone shows a U- or a J-shaped association with clinical outcomes and mortality. Such an inverse relationship fuels a controversy in the literature, named the 'obesity paradox', which associates better survival and fewer cardiovascular (CV) events in patients with elevated BMI afflicted with chronic diseases compared to non-obese patients. However, BMI cannot make the distinction between an elevated body weight due to high levels of lean vs. fat body mass. Generally, an excess of body fat (BF) is more frequently associated with metabolic abnormalities than a high level of lean body mass. Another explanation for the paradox is the absence of control for major individual differences in regional BF distribution. Adipose tissue is now considered as a key organ regarding the fate of excess dietary lipids, which may determine whether or not body homeostasis will be maintained (metabolically healthy obesity) or a state of inflammation/insulin resistance will be produced, with deleterious CV consequences. Obesity, particularly visceral obesity, also induces a variety of structural adaptations/alterations in CV structure/function. Adipose tissue can now be considered as an endocrine organ orchestrating crucial interactions with vital organs and tissues such as the brain, the liver, the skeletal muscle, the heart and blood vessels themselves. Thus, the evidence reviewed in this paper suggests that adipose tissue quality/function is as important, if not more so, than its amount in determining the overall health and CV risks of overweight/obesity.11/2013; 56(4):369-381. DOI:10.1016/j.pcad.2013.10.016