Rosiglitazone and Cardiovascular Risk

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Abstract
In this issue of the Journal, Nissen and Wolski1 report the results of a meta-analysis of treatment trials of rosiglitazone, as compared either with other therapies for type 2 diabetes or with placebo. Eligible studies included randomized trials that lasted for at least 24 weeks. The prespecified primary end points of interest were myocardial infarction and death from cardiovascular causes. The authors identified 42 eligible studies, many of which were small or short-term trials, that included a total of 158 myocardial infarctions and 61 deaths from cardiovascular causes. They used the Peto method to combine data from the trials. In this meta-analysis, rosiglitazone was associated with a significant increase in the risk of myocardial infarction (odds ratio, 1.43; 95% confidence interval [CI], 1.03 to 1.98; P=0.03) and a borderline-significant finding for death from cardiovascular causes (odds ratio, 1.64; 95% CI, 0.98 to 2.74; P=0.06).