Cited by 81Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsChronic Kidney Disease and Diabetes

Pioglitazone for the primary and secondary prevention of cardiovascular and renal outcomes in patients with or at high risk of type 2 diabetes mellitus: a meta-analysis

Zhou, Yue, Huang, Yajing, Ji, Xiaoyun, Wang, Xiang, Shen, Liyan, Wang, Yangang·2020·The Journal of Clinical Endocrinology & Metabolism

Abstract

Context The goal of the meta-analysis was to evaluate the effect of pioglitazone on the primary and secondary prevention of cardiovascular diseases (CVDs) and renal adverse events in patients with or at high risk of type 2 diabetes mellitus (T2DM). Design Randomized controlled trials (RCTs) comparing pioglitazone with any control were identified through PubMed, Embase, and the Cochrane Library. Cardiovascular outcomes included major adverse cardiovascular events (MACEs, defined as the composite of nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death), hospitalization for heart failure, and all-cause mortality. Renal outcomes included change in urinary albumin to creatinine ratio and 24-hour urinary protein excretion. Weighted mean difference (WMD) and risk ratio (RR) with 95% confidence intervals (CIs) were pooled. Results A total of 26 studies with 19 645 participants were enrolled. Pioglitazone reduced the risk of MACE (RR, 0.8 [95% CI, 0.7-0.9]), with benefit only seen in patients with a history of established CVDs (0.8 [0.7-0.9]) and not in those without (1.0 [0.7-1.3]). Regarding the individual components, pioglitazone reduced the risk of nonfatal myocardial infarction (0.8 [0.6-1.0]) and nonfatal stroke (0.8 [0.7-0.9]), which was confined to patients with a history of established CVDs, whereas no treatment effect was found on cardiovascular death (1.0 [0.7-1.2]) regardless of the presence of established CVDs. Pioglitazone increased the risk of hospi…

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Crossref · 10.1210/clinem/dgz252

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Authors
Zhou, Y., Huang, Y., Ji, X., Wang, X., Shen, L., & Wang, Y.
Affiliations
Qingdao University (CN)
Corresponding author
  • Shen, Liyan
  • Wang, Yangang
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2019-12-10
Volume
105
Issue
5
Pages
1670-1681
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2996104596
Cited by
81
References
56
Citations by year
2026: 7 · 2025: 12 · 2024: 18 · 2023: 15 · 2022: 13 · 2021: 11 · 2020: 5
FWCI
1.11
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
pioglitazone, type 2 diabetes, major adverse cardiovascular events, cardiovascular disease prevention, heart failure hospitalization, all-cause mortality, albuminuria, proteinuria, renal outcomes, myocardial infarction, stroke, cardiovascular mortality, thiazolidinediones, drug safety and efficacy, renal function, high-risk patients
MeSH terms
Pioglitazone, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diabetic Nephropathies, Female, Humans, Kidney Diseases, Male, Middle Aged, Primary Prevention, Randomized Controlled Trials as Topic, Treatment Outcome, Chemoprevention, Secondary Prevention

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