Uncertain effects of rosiglitazone on the risk for myocardial infarction and cardiovascular death.

Abstract:

: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.

journal_name

Ann Intern Med

authors

Diamond GA,Bax L,Kaul S

doi

10.7326/0003-4819-147-8-200710160-00182

subject

Has Abstract

pub_date

2007-10-16 00:00:00

pages

578-81

issue

8

eissn

0003-4819

issn

1539-3704

pii

0000605-200710160-00182

journal_volume

147

pub_type

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