Evidence mapPaperPMID 19235778Full record

ArticlePharmacoepidemiology and drug safety2009

Relationship between thiazolidinedione use and cardiovascular outcomes and all-cause mortality among patients with diabetes: a time-updated propensity analysis.

Zeina A Habib, Leonidas Tzogias, Suzanne L Havstad, Karen Wells, George Divine, David E Lanfear, Jeffrey Tang, Richard Krajenta, Manel Pladevall, L Keoki Williams

Abstract readComparative Study
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 5 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Thiazolidinediones for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
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  7. Altered taste perception and nutritional status among hemodialysis patients.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2013
    Trial
  8. Review
  9. Article
  10. Review
  11. PPARPPAR research · 2017
    Review
  12. Article
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  14. Review
  15. Differing effects of metformin on glycemic control by race-ethnicity.The Journal of clinical endocrinology and metabolism · 2014
    Article
  16. Article
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  18. Article
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Zeina A HabibDepartment of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
Leonidas Tzogias
Suzanne L Havstad
Karen Wells
George Divine
David E Lanfear
Jeffrey Tang
Richard Krajenta
Manel Pladevall
L Keoki Williams

Funding

VALIDATION OF ADHERENCE DATA--USE IN CLINICAL PRACTICER01DK064695 · HENRY FORD HEALTH SYSTEM · 2003 to 2005
$755k
USING INFORMATION TECHNOLOGY TO IMPROVE ASTHMA ADHERENCER01HL079055 · HENRY FORD HEALTH SYSTEM · 2005 to 2005
$358k
NHLBI NIH HHS R01 HL079055NHLBI NIH HHS R01HL079055NIDDK NIH HHS R01 DK064695NIDDK NIH HHS R01DK64695
6 · The paper itself

Abstract

purposeTo investigate the association of the thiazolidinediones (TZDs), rosiglitazone, and pioglitazone, together and individually on the risk of cardiovascular outcomes and all-cause mortality, using time-updated propensity score adjusted analysis.

methodsWe conducted a retrospective cohort study in a large vertically integrated health system in southeast Michigan. Cohort inclusion criteria included adult patients with diabetes treated with oral medications and followed longitudinally within the health system between 1 January 2000 and 1 December 2006. The primary outcome was fatal and non-fatal acute myocardial infarction (AMI). Secondary outcomes included hospitalizations for congestive heart failure (CHF), fatal, and non-fatal cerebrovascular accidents (CVA) and transient ischemic attacks (TIA), combined coronary heart disease (CHD) events, and all-cause mortality.

results19,171 patients were included in this study. Use of TZDs (adjusted hazard ratio (aHR) with propensity adjustment (PA), 0.92; 95% confidence interval (CI) 0.73-1.17), rosiglitazone (aHR with PA, 1.06; 95%CI 0.66-1.70), and pioglitazone (aHR with PA, 0.91; 95%CI 0.69-1.21) was not associated with a higher risk of AMI. However, pioglitazone use was associated with a reduction in all-cause mortality (aHR with PA, 0.60; 95%CI 0.42-0.96). Compared with rosiglitazone, pioglitazone use was associated with a lower risk of all outcomes assessed, particularly CHF (p = 0.013) and combined CHD events (p = 0.048).

conclusionsOur findings suggest that pioglitazone may have a more favorable risk profile when compared to rosiglitazone, arguing against a singular effect for TZDs on cardiovascular outcomes.

Indexed as

Acute DiseaseCardiovascular DiseasesCohort StudiesData Interpretation, StatisticalDiabetes Mellitus, Type 2Disease ProgressionDrug Therapy, CombinationFemaleHospitalizationHumansHypoglycemic AgentsMaleMiddle AgedMyocardial InfarctionPioglitazoneProportional Hazards ModelsHypoglycemic AgentsPioglitazoneRosiglitazoneThiazolidinediones

Identifiers

PMID19235778
PMCPMC2919167

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.