Rosiglitazone treatment and cardiovascular disease in the Veterans Affairs Diabetes Trial

from the VADT Research Group

Research output: Contribution to journalArticle

13 Citations (Scopus)

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±9years. Participants were recruited between 1 December 2000 and 31 May 2003, and were followed for 5-7.5years (median 5.6) with a final visit by 31 May 2008. Rosiglitazone (4mg and 8mg 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 [4mg: hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.49-0.81 and 8mg: 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 8mg/day rosiglitazone); however, the effect on MI was less evident for 8mg/day and not significant for 4mg/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.

Original languageEnglish (US)
Pages (from-to)949-955
Number of pages7
JournalDiabetes, Obesity and Metabolism
Volume17
Issue number10
DOIs
StatePublished - Oct 1 2015

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rosiglitazone
Veterans
Cardiovascular Diseases
Myocardial Infarction
Type 2 Diabetes Mellitus
Therapeutics
Confidence Intervals
Survival Analysis
Group Psychotherapy

Keywords

  • Cardiovascular disease
  • Older adults
  • Rosiglitazone
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Rosiglitazone treatment and cardiovascular disease in the Veterans Affairs Diabetes Trial. / from the VADT Research Group.

In: Diabetes, Obesity and Metabolism, Vol. 17, No. 10, 01.10.2015, p. 949-955.

Research output: Contribution to journalArticle

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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±9years. Participants were recruited between 1 December 2000 and 31 May 2003, and were followed for 5-7.5years (median 5.6) with a final visit by 31 May 2008. Rosiglitazone (4mg and 8mg 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 [4mg: hazard ratio (HR) 0.63, 95{\%} confidence interval (CI) 0.49-0.81 and 8mg: 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 8mg/day rosiglitazone); however, the effect on MI was less evident for 8mg/day and not significant for 4mg/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.",
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author = "{from the VADT Research Group} and Florez, {Hermes J} and Reaven, {P. D.} and G. Bahn and T. Moritz and S. Warren and Marks, {Jennifer B} and D. Reda and W. Duckworth and C. Abraira and R. Hayward and N. Emanuele",
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AU - Warren, S.

AU - Marks, Jennifer B

AU - Reda, D.

AU - Duckworth, W.

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AU - Emanuele, N.

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AB - 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±9years. Participants were recruited between 1 December 2000 and 31 May 2003, and were followed for 5-7.5years (median 5.6) with a final visit by 31 May 2008. Rosiglitazone (4mg and 8mg 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 [4mg: hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.49-0.81 and 8mg: 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 8mg/day rosiglitazone); however, the effect on MI was less evident for 8mg/day and not significant for 4mg/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.

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