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Week of February 22, 2009 < Back ¦ 2009 ¦ Home

Hot Paper in Medicine

"Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes," by Steven E. Nissen and Kathy Wolski, New England Journal of Medicine, 356(24): 2457-71, 14 June 2007.

[Authors' affiliation: Cleveland Clinic, OH]

Abstract: "BACKGROUND Rosiglitazone is widely used to treat patients with type 2 diabetes mellitus, but its effect on cardiovascular morbidity and mortality has not been determined. METHODS We conducted searches of the published literature, the Web site of the Food and Drug Administration, and a clinical-trials registry maintained by the drug manufacturer (GlaxoSmithKline). Criteria for inclusion in our meta-analysis included a study duration of more than 24 weeks, the use of a randomized control group not receiving rosiglitazone, and the availability of outcome data for myocardial infarction and death from cardiovascular causes. Of 116 potentially relevant studies, 42 trials met the inclusion criteria. We tabulated all occurrences of myocardial infarction and death from cardiovascular causes. RESULTS Data were combined by means of a fixed-effects model. In the 42 trials, the mean age of the subjects was approximately 56 years, and the mean baseline glycated hemoglobin level was approximately 8.2%. In the rosiglitazone group, as compared with the control group, the odds ratio for myocardial infarction was 1.43 (95% confidence interval [CI], 1.03 to 1.98; P=0.03), and the odds ratio for death from cardiovascular causes was 1.64 (95% CI, 0.98 to 2.74; P=0.06). CONCLUSIONS Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. Our study was limited by a lack of access to original source data, which would have enabled time-to-event analysis. Despite these limitations, patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with rosiglitazone for type 2 diabetes."

This 2007 report from the New England Journal of Medicine was cited 50 times in current journal articles indexed by Clarivate Analytics during September-October 2008. Repeating its performance from the previous count for July-August, this report currently stands as the third-most-cited medicine paper published in the last two years, aside from reviews. Prior to the most recent bimonthly count, citations to the paper have accrued as follows:

July-August 2008: 69 citations
May-June 2008: 53
March-April 2008: 78
January-February 2008: 73
November-December 2007: 52
September-October 2007: 37
July-August 2007: 13
May-June 2007: 3

Total citations to date: 428

SOURCE: Hot Papers Database (Included with a subscription to the print newsletter Science Watch®, available from the Research Services Group of Thomson Reuters. Packaged on a CD that is mailed with each Science Watch issue, the Hot Papers Database contains data on hundreds of highly cited papers published during the last two years. User interface permits searching by author, organization, journal, field, and more. Total citations, as well as citations accrued during successive bimonthly periods, can be assessed and graphed. An updated CD containing the most recent bimonthly data is mailed with every new issue of Science Watch, six times a year. The CD also includes an electronic version of the Science Watch issue in HTML format, for personal desktop access.

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