Thiazolidinediones and Increased MI Risk: A Class Effect?

New meta-analyses support an increased risk for MI with rosiglitazone, but not with pioglitazone.

Controversy continues regarding the possible association of thiazolidinediones (TZDs) with cardiovascular risk. Two meta-analyses published in JAMA shed new light on the subject.

In the first study, investigators assessed the incidence of MI, death, or stroke with pioglitazone in 19 randomized trials (16,390 patients), including the large PROactive study (Journal Watch Cardiology Nov 18 2005). In the meta-analysis, pioglitazone was associated with an increased rate of serious heart failure (hazard ratio, 1.41; P=0.002), but with a reduced risk for a composite of death, MI, and stroke (HR, 0.82, P=0.005), compared with controls.

In the second study, investigators conducted a meta-analysis of four long-term trials of rosiglitazone in 14,291 pat…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

Thiazolidinediones and Increased MI Risk: A Class Effect?

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Reviewing Author