PURPOSE: To investigate the association of the thiazolidinediones (TZDs), rosiglitazone, and pioglitazone, together and individually on the risk of cardiovascular outcomes and all-cause mortality, using time-updated propensity score adjusted analysis. METHODS: We conducted a retrospective cohort study in a large vertically integrated health system in southeast Michigan. Cohort inclusion criteria included adult patients with diabetes treated with oral medications and followed longitudinally within the health system between 1 January 2000 and 1 December 2006. The primary outcome was fatal and non-fatal acute myocardial infarction (AMI). Secondary outcomes included hospitalizations for congestive heart failure (CHF), fatal, and non-fatal cerebrovascular accidents (CVA) and transient ischemic attacks (TIA), combined coronary heart disease (CHD) events, and all-cause mortality. RESULTS: 19,171 patients were included in this study. Use of TZDs (adjusted hazard ratio (aHR) with propensity adjustment (PA), 0.92; 95% confidence interval (CI) 0.73-1.17), rosiglitazone (aHR with PA, 1.06; 95%CI 0.66-1.70), and pioglitazone (aHR with PA, 0.91; 95%CI 0.69-1.21) was not associated with a higher risk of AMI. However, pioglitazone use was associated with a reduction in all-cause mortality (aHR with PA, 0.60; 95%CI 0.42-0.96). Compared with rosiglitazone, pioglitazone use was associated with a lower risk of all outcomes assessed, particularly CHF (p = 0.013) and combined CHD events (p = 0.048). CONCLUSIONS: Our findings suggest that pioglitazone may have a more favorable risk profile when compared to rosiglitazone, arguing against a singular effect for TZDs on cardiovascular outcomes.
PURPOSE: To investigate the association of the thiazolidinediones (TZDs), rosiglitazone, and pioglitazone, together and individually on the risk of cardiovascular outcomes and all-cause mortality, using time-updated propensity score adjusted analysis. METHODS: We conducted a retrospective cohort study in a large vertically integrated health system in southeast Michigan. Cohort inclusion criteria included adult patients with diabetes treated with oral medications and followed longitudinally within the health system between 1 January 2000 and 1 December 2006. The primary outcome was fatal and non-fatal acute myocardial infarction (AMI). Secondary outcomes included hospitalizations for congestive heart failure (CHF), fatal, and non-fatal cerebrovascular accidents (CVA) and transient ischemic attacks (TIA), combined coronary heart disease (CHD) events, and all-cause mortality. RESULTS: 19,171 patients were included in this study. Use of TZDs (adjusted hazard ratio (aHR) with propensity adjustment (PA), 0.92; 95% confidence interval (CI) 0.73-1.17), rosiglitazone (aHR with PA, 1.06; 95%CI 0.66-1.70), and pioglitazone (aHR with PA, 0.91; 95%CI 0.69-1.21) was not associated with a higher risk of AMI. However, pioglitazone use was associated with a reduction in all-cause mortality (aHR with PA, 0.60; 95%CI 0.42-0.96). Compared with rosiglitazone, pioglitazone use was associated with a lower risk of all outcomes assessed, particularly CHF (p = 0.013) and combined CHD events (p = 0.048). CONCLUSIONS: Our findings suggest that pioglitazone may have a more favorable risk profile when compared to rosiglitazone, arguing against a singular effect for TZDs on cardiovascular outcomes.
Authors: Catherine B Johannes; Carol E Koro; Sherry G Quinn; Jennifer A Cutone; John D Seeger Journal: Pharmacoepidemiol Drug Saf Date: 2007-05 Impact factor: 2.890
Authors: Steven E Kahn; Steven M Haffner; Mark A Heise; William H Herman; Rury R Holman; Nigel P Jones; Barbara G Kravitz; John M Lachin; M Colleen O'Neill; Bernard Zinman; Giancarlo Viberti Journal: N Engl J Med Date: 2006-12-04 Impact factor: 91.245
Authors: H C Gerstein; S Yusuf; J Bosch; J Pogue; P Sheridan; N Dinccag; M Hanefeld; B Hoogwerf; M Laakso; V Mohan; J Shaw; B Zinman; R R Holman Journal: Lancet Date: 2006-09-23 Impact factor: 79.321
Authors: Philip D Home; Stuart J Pocock; Henning Beck-Nielsen; Ramón Gomis; Markolf Hanefeld; Nigel P Jones; Michel Komajda; John J V McMurray Journal: N Engl J Med Date: 2007-06-05 Impact factor: 91.245
Authors: Andrew T McAfee; Carol Koro; Joan Landon; Najat Ziyadeh; Alexander M Walker Journal: Pharmacoepidemiol Drug Saf Date: 2007-07 Impact factor: 2.890
Authors: L Keoki Williams; Edward L Peterson; Karen Wells; Brian K Ahmedani; Rajesh Kumar; Esteban G Burchard; Vimal K Chowdhry; David Favro; David E Lanfear; Manel Pladevall Journal: J Allergy Clin Immunol Date: 2011-10-21 Impact factor: 10.793
Authors: Elisabetta Patorno; Elizabeth M Garry; Amanda R Patrick; Sebastian Schneeweiss; Victoria G Gillet; Olesya Zorina; Dorothee B Bartels; John D Seeger Journal: Drug Saf Date: 2015-03 Impact factor: 5.606
Authors: Susan E Andrade; Leslie R Harrold; Jennifer Tjia; Sarah L Cutrona; Jane S Saczynski; Katherine S Dodd; Robert J Goldberg; Jerry H Gurwitz Journal: Pharmacoepidemiol Drug Saf Date: 2012-01 Impact factor: 2.890
Authors: David E Lanfear; Tara N Hrobowski; Edward L Peterson; Karen E Wells; Tanmay V Swadia; John A Spertus; L Keoki Williams Journal: Circ Heart Fail Date: 2012-01-19 Impact factor: 8.790
Authors: Elisabetta Patorno; Amanda R Patrick; Elizabeth M Garry; Sebastian Schneeweiss; Victoria G Gillet; Dorothee B Bartels; Elvira Masso-Gonzalez; John D Seeger Journal: Diabetologia Date: 2014-09-12 Impact factor: 10.122
Authors: Sami Hayek; Fabrizio Canepa Escaro; Assad Sattar; Steven Gamalski; Karen E Wells; George Divine; Brian K Ahmedani; David E Lanfear; Manel Pladevall; L Keoki Williams Journal: Am J Cardiol Date: 2012-12-04 Impact factor: 2.778