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- Title
Rosiglitazone treatment and cardiovascular disease in the Veterans Affairs Diabetes Trial.
- Authors
Florez, H.; Reaven, P. D.; Bahn, G.; Moritz, T.; Warren, S.; Marks, J.; Reda, D.; Duckworth, W.; Abraira, C.; Hayward, R.; Emanuele, N.
- Abstract
Aims To evaluate the relationship between patterns of rosiglitazone use and cardiovascular ( CV) outcomes in the Veterans Affairs Diabetes Trial ( 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 December 2000 and 31 May 2003, and were followed for 5-7.5 years (median 5.6) with a final visit by 31 May 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.
- Subjects
ROSIGLITAZONE; CARDIOVASCULAR diseases; TYPE 2 diabetes treatment; PHARMACODYNAMICS; DRUG dosage; CONFIDENCE intervals
- Publication
Diabetes, Obesity & Metabolism, 2015, Vol 17, Issue 10, p949
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.12487