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Rosiglitazone treatment and cardiovascular disease in the V eterans A ffairs D iabetes Trial
Author(s) -
Florez H.,
Reaven P. D.,
Bahn G.,
Moritz T.,
Warren S.,
Marks J.,
Reda D.,
Duckworth W.,
Abraira C.,
Hayward R.,
Emanuele N.
Publication year - 2015
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12487
Subject(s) - rosiglitazone , medicine , hazard ratio , confidence interval , type 2 diabetes , myocardial infarction , randomized controlled trial , proportional hazards model , diabetes mellitus , lower risk , endocrinology , insulin
Aims To evaluate the relationship between patterns of rosiglitazone use and cardiovascular ( CV ) outcomes in the V eterans A ffairs D iabetes T rial ( VADT ). Methods Time‐dependent survival analyses, case–control and 1 : 1 propensity matching approaches were used to examine the relationship between patterns of rosiglitazone use and CV outcomes in the VADT , a randomized controlled study that assessed the effect of intensive glycaemic control on CV outcomes in 1791 patients with type 2 diabetes ( T2D ) whose mean age was 60.4 ± 9 years. Participants were recruited between 1 D ecember 2000 and 31 M ay 2003, and were followed for 5–7.5 years (median 5.6) with a final visit by 31 M ay 2008. Rosiglitazone (4 mg and 8 mg daily) was initiated per protocol in both the intensive‐therapy and standard‐therapy groups. Main outcomes included a composite CV outcome, CV death and myocardial infarction ( MI ). Results Both daily doses of rosiglitazone were associated with lower risk for the primary composite CV outcome [4 mg: hazard ratio ( HR ) 0.63, 95% confidence interval ( CI ) 0.49–0.81 and 8 mg: HR 0.60, 95% CI 0.49–0.75] after adjusting for demographic and clinical covariates. A reduction in CV death was also observed ( HR 0.25, p < 0.001, for both 4 and 8 mg/day rosiglitazone); however, the effect on MI was less evident for 8 mg/day and not significant for 4 mg/day. Conclusions In older patients with T2D the use of rosiglitazone was associated with decreased risk of the primary CV composite outcome and CV death. Rosiglitazone use did not lead to a higher risk of MI .