Stroke and cardiovascular morbidity and mortality associated with rosiglitazone use in elderly diabetic patients.

The objective was to evaluate the cardiovascular risks associated with rosiglitazone in diabetic patients. We conducted matched nested case-control studies in a retrospective population-based cohort of all elderly diabetic patients living in Quebec throughout 2001 and 2002. Study end-points were: all-cause and cardiovascular death, hospital admission for AMI, CHF and stroke.Twenty controls per case, matched for age, gender and date of cohort entry, were randomly drawn from each case's risk set. Conditional logistic regressions were adjusted for co-morbidities and other drug exposures. The risk of hospital admission for AMI (HR 1.41, 95% CI 1.21-1.65) and CHF (HR 1.94, 95% CI 1.71-2.19) was increased by the use of rosiglitazone. However, exposure to rosiglitazone was not associated with an increased risk of cardiovascular mortality (HR 0.88, 95% CI 0.69-1.12) and all-causes mortality (HR 0.87, 95% CI 0.76-0.99).The risk of hospital admission for stroke was not significantly affected by rosiglitazone use. Further studies are needed to better understand the mechanisms explaining these associations.