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The comparative-effectiveness trend in clinical research has recently reached diabetes medications (JW Cardiol Jan 7 2009). Thiazolidinediones are insulin-sensitizing agents that improve glycemic control but increase the risk for fluid retention and heart failure. Currently, clinicians have only two choices of thiazolidinedione — rosiglitazone and pioglitazone — and safety concerns have emerged about rosiglitazone. Investigators compared the relative cardiovascular safety of these two agents in a Canadian population of 39,736 adults with diabetes, aged ≥66, who began thiazolidinedione treatment between April 1, 2002, and March 31, 2008.
During a median follow-up of just under 300 days, the rosiglitazone recipients had a higher rate of death …