Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria.
Diabetes Obes Metab. 2010 Dec;12(12):1023-35. doi: 10.1111/j.1463-1326.2010.01262.x.
Meta-analyses of clinical trials suggest that the use of the thiazolidinedione (TZD), rosiglitazone, in patients with type 2 diabetes mellitus may increase the risk of myocardial ischaemic events by 30-40%. Although these controversial data must be interpreted with caution, in the absence of definitive prospective cardiovascular (CV) outcomes data, they represent a prominent source of evidence concerning the CV safety of rosiglitazone. The results of meta-analyses and a large randomized-controlled CV outcomes trial provide strong evidence that pioglitazone does not increase the risk of coronary events. This article clarifies the clinical significance of these meta-analytical findings alongside other sources of evidence and assesses their impact on evolving treatment guidelines and recommendations for the use of TZDs in patients with type 2 diabetes.
临床试验的荟萃分析表明，2 型糖尿病患者使用噻唑烷二酮（TZD）类药物罗格列酮可能会使心肌缺血事件的风险增加 30-40%。尽管这些有争议的数据必须谨慎解释，但在缺乏明确的前瞻性心血管（CV）结局数据的情况下，它们代表了有关罗格列酮 CV 安全性的重要证据来源。荟萃分析和一项大型随机对照 CV 结局试验的结果提供了强有力的证据，表明吡格列酮不会增加冠心病事件的风险。本文阐明了这些荟萃分析结果与其他证据来源的临床意义，并评估了它们对不断发展的治疗指南和 2 型糖尿病患者 TZD 使用建议的影响。
