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BMC Cardiovascular Disorders

, 17:96

Non-coronary artery cardiac disease


BackgroundAccumulating evidence suggests that thiazolidinediones TZDs may exert protective effects in atrial fibrillation AF. The present meta-analysis investigated the association between TZD use and the incidence of AF in diabetic patients.

MethodsElectronic databases were searched until December 2016. Of the 346 initially identified records, 3 randomized clinical trials RCTs and 4 observational studies with 130,854 diabetic patients were included in the final analysis.

ResultsPooled analysis of the included studies demonstrated that patients treated with TZDs had approximately 30% lower risk of developing AF compared to controls odds ratio OR: 0.73, 95% confidence interval CI: 0.62 to 0.87, p = 0.0003. This association was consistently observed for both new onset AF OR =0.77, p = 0.002 and recurrent AF OR =0.41, p = 0.002, pioglitazone use OR =0.56, p = 0.04 but not rosiglitazone use OR =0.78, p = 0.12. The association between TZD use and AF incidence was not significant in the pooled analysis of three RCTs OR =0.77, 95% CI = 0.53–1.12, p = 0.17, but was significantly in the pooled analysis of the four observational studies OR =0.71, p = 0.0003.

ConclusionsThis meta-analysis suggests that TZDs may confer protection against AF in the setting of diabetes mellitus DM. This class of drugs can be used as upstream therapy for DM patients to prevent the development of AF. Further large-scale RCTs are needed to determine whether TZDs use could prevent AF in the setting of DM.

KeywordsAtrial fibrillation Diabetes mellitus Thiazolidinediones Pioglitazone Rosiglitazone Meta-analysis AbbreviationsAFAtrial fibrillation

CHFCongestive heart failure

CIConfidence interval

CRPC-reactive protein

DMDiabetes mellitus

OROdds ratio

PPAR-γPeroxisome proliferator-activated receptor-γ

RCTsRandomized clinical trials


Zhiwei Zhang and Xiaowei Zhang contributed equally to this work.

Autor: Zhiwei Zhang - Xiaowei Zhang - Panagiotis Korantzopoulos - Konstantinos P. Letsas - Gary Tse - Mengqi Gong - Lei Meng - Gu


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