Table 4.
Estimated Effect of Rosiglitazone or Pioglitazone on the Rate of Acute Myocardial Infarction Relative to Combined Use of Metformin and a Sulfonylureaa
| No. (%) of Patients |
||||
|---|---|---|---|---|
| Acute MI Cases (n=2316) |
Controls (n=9700) |
OR (95% CI) |
||
| Time of Drug Use | Crude | Adjustedb | ||
| Start of rosiglitazone | ||||
| Within 180 days before index date | 80 (3.5) | 300 (3.1) | 0.99 (0.76–1.28) | 1.00 (0.72–1.39) |
| Within 90 days before index date | 54 (2.3) | 150 (1.6) | 1.32 (0.96–1.83) | 1.29 (0.85–1.94) |
| Within 91–180 days before index date | 26 (1.1) | 150 (1.6) | 0.65 (0.42–1.01) | 0.68 (0.40–1.16) |
| With metformin + a sulfonylurea within 180 days before index date |
62 (2.7) | 209 (2.2) | 1.08 (0.81–1.46) | 1.04 (0.72–1.51) |
| Prevalent use of rosiglitazone | 240 (10.4) | 1016 (10.5) | 0.89 (0.76–1.04) | 0.87 (0.71–1.06) |
| Start of pioglitazone | ||||
| Within 180 days before index date | 70 (3.0) | 269 (2.8) | 1.00 (0.76–1.32) | 1.04 (0.74–1.45) |
| Within 90 days before index date | 37 (1.6) | 130 (1.3) | 1.10 (0.76–1.59) | 1.15 (0.73–1.81) |
| Within 91–180 days before index date | 33 (1.4) | 139 (1.4) | 0.91 (0.61–1.34) | 0.93 (0.57–1.50) |
| With metformin + a sulfonylurea within 180 days before index date |
57 (2.5) | 196 (2.0) | 1.11 (0.82–1.51) | 1.16 (0.80–1.68) |
| Prevalent use of pioglitazone | 198 (8.6) | 783 (8.1) | 0.96 (0.81–1.14) | 0.99 (0.80–1.23) |
| Prevalent use of metformin + a sulfonylurea | 1529 (66.0) | 5809 (59.9) | 1.00 | 1.00 |
OR = odds ratio; CI = confidence interval.
Excludes data for 23 case subjects and 57 control subjects who used both pioglitazone and rosiglitazone.
Adjusted for sex, race-ethnicity, residence in long-term care, number of inpatient hospitalizations, Charlson comorbidity index, angina pectoris, previous myocardial infarction, cerebrovascular disease, unstable angina, other cardiovascular disease, hyperlipidemia, hypertension, previous coronary revascularization, chronic pulmonary disease, and use of the following drugs: first-generation sulfonylureas, α-glucosidase inhibitors, cholesterol-lowering drugs, diuretics, β-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, nitrates, α-blockers, antiplatelet agents, digoxin, antiarrhythmics, benzodiazepines, nonbenzodiazepine hypnotics, anticonvulsants, opiates, atypical antipsychotics, antidepressants, antibiotics, corticosteroids, selective estrogen receptor modulators, and hormone replacements.