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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 .

Rosiglitazone treatment and cardiovascular disease in the V eterans A ffairs D iabetes Trial