Rosiglitazone Treatment and Cardiovascular Disease in the Veterans Affairs Diabetes Trial Journal Article

Authors: Florez, H.; Reaven, P.; Bahn, G.; Moritz, T.; Warren, S; Marks, J.; Reda, D; Duckworth, W.; Abraira, C.; Hayward, R.; Emanuele, N; from the VADT Research Group.
Article Title: Rosiglitazone Treatment and Cardiovascular Disease in the Veterans Affairs Diabetes Trial
Abstract: AIMS: Rosiglitazone may be associated with increased risk of cardiovascular (CV) disease in patients with type 2 diabetes (T2D). We evaluated the relationship between patterns of rosiglitazone use and CV outcomes in the Veterans Affairs Diabetes Trial (VADT). MATERIALS AND METHODS: Time-dependent survival analyses, case-control and 1:1 propensity matching approaches were used to examine this relationship in the VADT, a randomized controlled study that assessed the effect of intensive glycemic control on CV outcomes in 1791 T2D patients (mean age of 60.4 +/- 9 years). Participants were recruited from December 1, 2000, through May 31, 2003, and were followed for 5 to 7.5 years (median 5.6) with the final visit by May 31, 2008. Rosiglitazone (4 mg and 8 mg daily) was initiated per protocol in both intensive-therapy and standard-therapy groups. Main outcomes include 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 (HR 0.63; 95% CI 0.49-0.81 and HR 0.60; 95% CI 0.49-0.75, respectively) after adjusting for demographic and clinical covariates. A reduction of 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 higher risk of MI.
Journal Title: Diabetes, obesity metabolism
Volume: 17
Issue: 10
ISSN: 1463-1326; 1462-8902
Publisher: Unknown  
Date Published: 2015
Start Page: 949
End Page: 955
Language: ENG
Notes: LR: 20150513; CI: This article is protected by copyright. All rights reserved.; JID: 100883645; OTO: NOTNLM; 2014/11/04 [received]; 2015/03/31 [revised]; 2015/05/02 [accepted]; aheadofprint