Diabetes Drug May Lower Risk of Second Stroke, Heart Attack

Pioglitazone, a common diabetes drug that improves insulin sensitivity, can help lower the risk of a heart attack or a second stroke in patients who have already had a stroke, according to new research.

Because insulin resistance has been identified as a risk factor for strokes and heart attacks, researchers were curious whether pioglitazone would help patients who were susceptible to these cardiovascular events.
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To investigate their theory, researchers followed 3876 patients who had had an ischemic stroke or a transient ischemic attack (TIA) in the 6 months prior to enrollment and who didn’t have diabetes but were insulin resistant.

Then researchers randomly separated patients into 2 groups. Group 1, consisting of 1939 patients, received a daily dose of 45 mg of pioglitazone and group 2, consisting of 1937 patients, received a placebo.

After a median 4.8-year follow up, 9% of the pioglitazone group and 12% of the placebo group experienced a stroke or heart attack.

In addition, 4% of the pioglitazone group and 8% of the placebo group had developed diabetes. Other side effects included weight gain, edema, and bone fractures.

“The risk of stroke or myocardial infarction was lower among patients who received pioglitazone than among those who received placebo,” researchers concluded. “Pioglitazone was also associated with a lower risk of diabetes but with higher risks of weight gain, edema, and fracture.”

—Amanda Balbi

Reference:

Kernan WN, Viscoli CM, Furie KL, et al. Pioglitazone after ischemic stroke or transient ischemic attack. N Engl J Med. Published online February 17, 2016. doi:10.1056/NEJMoa1506930.