Different Effects of Thiazolidinediones on Cardiovascular Events among Type 2 Diabetic Patients Implanted with Bare Metal Stents: A Nationwide Study

Abstract

Background: This study aimed to evaluate the effect of thiazolidinediones (TZDs) on re-hospitalization rates for revascularization after bare-metal stent (BMS) implantation. Methods: Data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, were analyzed from March, 2000 to December, 2006. Type 2 diabetes subjects treated with BMS implantations who used TZDs (either rosiglitazone or pioglitazone) were compared with subjects not on TZDs (non-TZD group) to evaluate the risk of readmission for coronary revascularization. Endpoints were acute coronary syndrome (ACS) and readmission for revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery) after 3, 6, and 12 months. Results: In total, 6911 type 2 diabetes patients were hospitalized for BMS implantation (average follow-up, 294.4 ± 108.9 days). Rosiglitazone treatment in patients who received BMSs was associated with a higher risk of re-hospitalization for revascularization at 6 and 12 months (hazard ratio (HR) = 1.33; 95% CI: 1.08-1.64 and HR = 1.20 95% CI: 1.01-1.43). However, there were no significant differences between the pioglitazone and non-TZD groups. Conclusion: The use of rosiglitazone in type 2 diabetes patients after BMS implantation may increase the risk of re-hospitalization for revascularization. Our study suggests that rosiglitazone should be used cautiously in diabetes patients with BMS implantation.