Erland Erdmann, MD: From the Medizinische Klinik III der Universität zu Köln, Köln, Germany.

We analyzed a subgroup of 2445 subjects with diabetes, macrovascular disease, and previous myocardial infarction (MI) from the Prospective Pioglitazone Clinical Trial in Macrovascular Events to determine the effects of pioglitazone on mortality and macrovascular morbidity. Pioglitazone was shown to decrease the occurrence of adverse cardiac outcomes, including recurrent MI, in these high-risk subjects. This additional benefit of pioglitazone in patients with diabetes and a previous MI suggests that it may be appropriate to include this medication in the management strategy of patients with MI.