Cardiovascular preventive role of thiazolidinedione in patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention
Jinkwon Kim, Jimin Jeon, Joonsang Yoo, Minyoul Baik, Seok‐Jae Heo, Ji Woong RohABSTRACT
Background
Thiazolidinediones (TZD) are a class of oral antidiabetic medications that improve glycemic control and insulin sensitivity. We evaluated the cardiovascular outcomes according to thiazolidinedione (TZD) use in patients with type 2 diabetes mellitus (T2DM) undergoing percutaneous coronary intervention (PCI).
Methods
Using the national health claims database in South Korea, we constructed a cohort of type 2 diabetes mellitus patients who underwent PCI between 2015 and 2022. Patients were classified as TZD users or nonusers and matched at a 1:3 ratio using propensity score matching. Stratified Cox regression analysis was performed to evaluate the risk for the primary composite outcome, which included myocardial infarction (MI), stroke, and all‐cause death.
Results
Among 169,747 patients with type 2 diabetes mellitus who underwent PCI, 7.4% were TZD users. During a mean follow‐up of 3.63 ± 2.30 years, 31,813 patients (18.7%) experienced the primary outcome. In the stratified Cox regression analysis, which consisted of 12,597 TZD users and 37,791 nonusers, TZD treatment was associated with a lower risk of primary outcome (HR 0.87, 95% CI: 0.83–0.92, P < 0.001). No difference was observed in the risk of heart failure admission between TZD nonusers and users.
Conclusions
TZD treatment in type 2 diabetes mellitus patients undergoing PCI was associated with a reduced risk of adverse cardiovascular events.