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Two thiazolidinediones are available in the U.S.: pioglitazone (Actos) and rosiglitazone (Avandia). However, researchers have raised concerns about the cardiovascular safety of these drugs. In this retrospective cohort study, Canadian investigators assessed risk for myocardial infarction, heart failure, and death in nearly 40,000 older patients (age, ≥66) with type 2 diabetes who received pioglitazone or rosiglitazone during a 6-year period.
Overall, the composite endpoint of death, MI, and heart failure occurred in 5.3% of patients who took pioglitazone and in 6.9% of patients who took rosiglitazone; a significantly lower risk with pioglitazone persisted after adjustments for many potential confounders and drug doses (hazard ratio, 0.83). L…