Pioglitazone Lowers Recurrent Stroke Risk in Type 2 Diabetes Patients

Pioglitazone significantly reduces the risk of first-time stroke and recurrent stroke in high-risk patients with type 2 diabetes, a European group reports. Dr. Robert G. Wilcox, of University Hospital, Nottingham, UK, and colleagues conducted a subgroup analysis of patients in the PROspective pioglitAzone Clinical Trial In microVascular Events 04 (PROactive) trial.

Dr. Wilcox’s team compared macrovascular events in 984 patients with a history of stroke and 4254 without a history of stroke who were randomized to pioglitazone or placebo.

All subjects remained on their current medications for dyslipidemia, hypertension, and hyperglycemia, and were followed for an average of 34.5 months.

The primary end point was all-cause mortality, nonfatal MI, stroke, acute coronary syndrome, cardiac interventions, leg revascularization and amputation.

In patients who had had a stroke, the investigators found “a statistically significant beneficial effect of pioglitazone on the end points of fatal or nonfatal stroke (p = 0.0085) and cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction (p = 0.0467).”

Those with prior stroke also had higher event rates. No treatment effect was observed for a first stroke in patients without prior stroke.

Stroke 2007;38:865-873.
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