Document Detail


Uncertain effects of rosiglitazone on the risk for myocardial infarction and cardiovascular death.
MedLine Citation:
PMID:  17679700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A recent, widely publicized meta-analysis of 42 clinical trials concluded that rosiglitazone was associated with an approximately 43% increased risk for myocardial infarction and an approximately 64% increased risk for cardiovascular death. The sensitivity of these conclusions to several methodological choices was not assessed. The meta-analysis was not based on a comprehensive search for all studies that might yield evidence about rosiglitazone's cardiovascular effects. Studies were combined on the basis of a lack of statistical heterogeneity, despite substantial variability in study design and outcome assessment. The meta-analytic approach that was used required the exclusion of studies with zero events in the treatment and control groups. Alternative meta-analytic approaches that use continuity corrections show lower odds ratios that are not statistically significant. We conclude that the risk for myocardial infarction and death from cardiovascular disease for diabetic patients taking rosiglitazone is uncertain: Neither increased nor decreased risk is established.
Authors:
George A Diamond; Leon Bax; Sanjay Kaul
Publication Detail:
Type:  Journal Article     Date:  2007-08-06
Journal Detail:
Title:  Annals of internal medicine     Volume:  147     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-16     Completed Date:  2007-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-81     Citation Subset:  AIM; IM    
Affiliation:
Cedars-Sinai Medical Center and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. gadiamond@pol.net
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / chemically induced,  mortality*
Diabetes Mellitus, Type 2 / drug therapy*
Humans
Hypoglycemic Agents / adverse effects*
Meta-Analysis as Topic
Myocardial Infarction / chemically induced*
PPAR gamma / agonists
Research Design / standards
Risk Factors
Thiazolidinediones / adverse effects*
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/PPAR gamma; 0/Thiazolidinediones; 122320-73-4/rosiglitazone
Comments/Corrections
Comment In:
Ann Intern Med. 2007 Oct 16;147(8):585-7   [PMID:  17938398 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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