Evidence map›Paper›PMID 21415101›Full record

SynthesisBMJ (Clinical research ed.)2011

Comparative cardiovascular effects of thiazolidinediones: systematic review and meta-analysis of observational studies.

Yoon Kong Loke, Chun Shing Kwok, Sonal Singh

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 7 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

96 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Guideline
  8. Trial
  9. Effects of rosiglitazone on serum paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2013
    Trial
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36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Yoon Kong LokeSchool of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK. y.loke@uea.ac.uk
Chun Shing Kwok
Sonal Singh

Funding

NCRR NIH HHS 1KL2RR025006-03
6 · The paper itself

Abstract

objectiveTo determine the comparative effects of the thiazolidinediones (rosiglitazone and pioglitazone) on myocardial infarction, congestive heart failure, and mortality in patients with type 2 diabetes.

designSystematic review and meta-analysis of observational studies. DATA SOURCES: Searches of Medline and Embase in September 2010. STUDY SELECTION: Observational studies that directly compared the risk of cardiovascular outcomes for rosiglitazone and pioglitazone among patients with type 2 diabetes mellitus were included. DATA EXTRACTION: Random effects meta-analysis (inverse variance method) was used to calculate the odds ratios for cardiovascular outcomes with thiazolidinedione use. The I(2 )statistic was used to assess statistical heterogeneity.

resultsCardiovascular outcomes from 16 observational studies (4 case-control studies and 12 retrospective cohort studies), including 810,000 thiazolidinedione users, were evaluated after a detailed review of 189 citations. Compared with pioglitazone, use of rosiglitazone was associated with a statistically significant increase in the odds of myocardial infarction (n = 15 studies; odds ratio 1.16, 95% confidence interval 1.07 to 1.24; P < 0.001; I(2) = 46%), congestive heart failure (n = 8; 1.22, 1.14 to 1.31; P < 0.001; I(2) = 37%), and death (n = 8; 1.14, 1.09 to 1.20; P < 0.001; I(2) = 0%). Numbers needed to treat to harm (NNH), depending on the population at risk, suggest 170 excess myocardial infarctions, 649 excess cases of heart failure, and 431 excess deaths for every 100,000 patients who receive rosiglitazone rather than pioglitazone.

conclusionAmong patients with type 2 diabetes, use of rosiglitazone is associated with significantly higher odds of congestive heart failure, myocardial infarction, and death relative to pioglitazone in real world settings.

Indexed as

Diabetes Mellitus, Type 2Heart FailureHumansHypoglycemic AgentsMyocardial InfarctionPioglitazonePrognosisPublication BiasRisk FactorsRosiglitazoneThiazolidinedionesHypoglycemic AgentsPioglitazoneRosiglitazoneThiazolidinediones

Identifiers

PMID21415101
PMCPMC3230110

What Socratic holds

Textmetadata
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.