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Thiazolidinediones and cardiovascular outcomes

Undergraduate Centre, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK, anthony.barnett{at}heartofengland.nhs.uk

Diabetes mellitus is associated with a number of serious microvascular and macrovascular complications that have a devastating effect on quality of life and impose a heavy burden on healthcare systems. In order to decrease the risk of diabetes-related complications, individuals with diabetes should normally receive intensive and effective treatment for all metabolic disturbances, including hyperglycaemia. Thiazolidinediones are an important part of this therapeutic armamentarium, but are currently the subject of intense scrutiny following the publication of a meta-analysis reporting increased cardiovascular risk with rosiglitazone. Based on available data, the FDA has concluded that the use of rosiglitazone for the treatment of type 2 diabetes may be associated with a greater risk of myocardial ischaemic events than placebo, metformin or sulphonylureas and have added label warnings to the prescribing information until the results of long-term cardiovascular outcome trials become available. To date, increased cardiovascular risk has not been reported with pioglitazone and indeed there is evidence suggestive of cardiovascular protection. Thiazolidinediones are effective glucose-lowering agents, complementing existing treatment approaches and thus have a continuing role to play in the management of diabetes.

Key Words: cardiovascular disease • myocardial infarction • pioglitazone • rosiglitazone • thiazolidinedione • type 2 diabetes.

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The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 1, 45-49 (2008)
DOI: 10.1177/14746514080080011001


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Barnett, A. H Search for Related Content Social Bookmarking                         What's this?