In a multicentre, open-label study, we randomized 4447 peoplewith type 2 diabetes on metformin or sulfonylurea monotherapy
with a mean HbA1c of 7.9% to add-on rosiglitazone (n ¼ 2220) or to a combination of metformin and sulfonylurea
(n ¼ 2227) and followed them over 5.5 years on average. Heart failure hospitalizations and deaths were adjudicated by a
Clinical Endpoint Committee using pre-specified criteria. Independent predictors of HF events were identified out of a
group of 30 pre-specified clinical, demographic, and biological variables. In the rosiglitazone group, the risk of HF death
or hospitalization was doubled: HR ¼ 2.10 (95% CI, 1.35–3.27): the excess HF event rate was 2.6 (1.1–4.1) per 1000
person-years. An excess in HF deaths was observed (10 vs. two), including four HF deaths as first HF events. By contrast,
there was no increase in cardiovascular mortality or hospitalization (HR ¼ 0.99, 95% CI, 0.85–1.16) or in cardiovascular
deaths (60 vs. 71). Independent predictors of HF were rosiglitazone assignment, age, urinary albumin : creatinine ratio,
body mass index, and systolic blood pressure at baseline. A history of previous cardiovascular disease was not predictive
of HF. Duration of HF hospitalization and rate of HF re-hospitalization were similar in the two groups.