Effect of rosiglitazone on survival in patients with diabetes mellitus treated for coronary artery disease

Objectives The purpose of this study was to assess the impact of rosiglitazone on survival in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Methods We carried out a drug-exposure analysis in 801 patients with DM and CAD in a cardiac catheterization laboratory registry (490 patients treated with a percutaneous coronary intervention, 224 patients treated with coronary artery bypass grafting, and 87 patients treated with medication alone). Results A total of 193 patients (24.1%) were exposed to rosiglitazone. The median survival from the date of cardiac catheterization in the rosiglitazone group was 146.7 months versus 109.1 months in the unexposed group (P<0.001). At 5 years, the unadjusted survival was 82% in the rosiglitazone-exposed group versus 69% in the unexposed group (P<0.001). There was no difference in survival between rosiglitazone-exposed and rosiglitazone-unexposed patients in the groups treated with coronary artery bypass grafting or medical therapy (P = 0.37 and 0.11, respectively). In a multivariable model, rosiglitazone exposure had no effect on mortality (hazard ratio = 0.737; 95% confidence interval: 0.521-1.044, P = 0.86). Conclusion We conclude that exposure to rosiglitazone is not associated with increased mortality in diabetics who are treated for CAD. These findings support the notion that insulin sensitization with a thiazolidinedione is safe in carefully selected and treated patients with DM and CAD. Coron Artery Dis 23:354-358 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.