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Pioglitazone limits MI risk in Chinese adults

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February 14, 2019

Chinese adults with type 2 diabetes who use pioglitazone are at decreased risk for myocardial infarction compared with those who do not use the medication, according to findings published in the Journal of Diabetes.

“Given the link between insulin resistance and cardiovascular complications, as well as the effects of thiazolidinediones in reducing insulin resistance, thiazolidinediones may decrease cardiovascular risk among [type 2 diabetes] patients. Of the different types of thiazolidinediones, pioglitazone is the most commonly prescribed,” Yun Liu, MD, PhD, of the department of geriatrics endocrinology at the First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital in China, and colleagues wrote. “It is unclear whether the potential protective effects of pioglitazone on cardiovascular outcomes among [type 2 diabetes] patients can be generalized to the Chinese population.”

Liu and colleagues conducted a retrospective study of 71,783 adults with type 2 diabetes from the Clinical Data Repository of the First Affiliated Hospital of Nanjing Medical University in Jiangsu, China. Each patient was prescribed at least one oral antidiabetes drug, and their deidentified electronic health records from July 2005 to June 2017 were analyzed.

In the total cohort, 8,226 patients used pioglitazone (mean age, 55.1 years; 48.35% women), which was defined by an occurrence of pioglitazone prescription or dispensation during any 6-month interval during the study period. The remaining 63,557 patients (mean age, 57.9 years; 44.11% women) were labeled as nonusers of pioglitazone, according to the researchers.

MI incidence rates were lower in the pioglitazone group (2.55 per 1,000 person-years) compared with the non-pioglitazone group (1.24 per 1,000 person-years). Heart failure incidence rates were also lower in the pioglitazone group (3.86 per 1,000 person-years) compared with the non-pioglitazone group (2.44 per 1,000 person-years), and stroke incidence rates were lower in the pioglitazone group (0.52 per 1,000 person-years) compared with the non-pioglitazone group (0.21 per 1,000 person-years.), the researchers wrote.

They found that MI risk was 39% lower in the pioglitazone group compared with the non-pioglitazone group (RR = 0.61; 95% CI, 0.42-0.9), and nonsignificant decreases in risk for heart failure (RR = 0.82; 95% CI, 0.62-1.08) and stroke (RR = 0.47; 95% CI, 0.18-1.18) were observed in the pioglitazone group compared with the non-pioglitazone group.

“We found that the previously reported protective effect of pioglitazone on the risk of MI among Western [type 2 diabetes] patients was also observed among [type 2 diabetes] patients in China,” the researchers wrote. “The study findings also validated the favorable effects of pioglitazone on the risk of MI in a provincial medical institution patient population, which may be helpful for personalized decision making in [type 2 diabetes] treatment.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

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