Risk of cardiovascular disease and all-cause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: A meta-analysis of retrospective cohort studies

Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China.
Chinese medical journal (Impact Factor: 1.05). 12/2012; 125(23):4301-6. DOI: 10.3760/cma.j.issn.0366-6999.2012.23.025
Source: PubMed


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 [5] [6] [7]. Besides, high blood pressure, smoking, obesity and lack of physical activity are also risk factors for CVD [8] [9] [10]. "
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    • "An obvious relationship between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CDV) has been shown [1]. 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[2]. 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[11], card iac autonomic neuropathy[19], foot ulcers[20], and ch ron ic kidney d isease[4]. "
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    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 controls
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