Review: Statin plus thiazolidinedione use in patients with diabetes at high cardiovascular risk

People with type 2 diabetes carry an excess burden of cardiovascular risk that warrants close attention to risk factors in the majority of patients. Despite multifactorial intervention, often including statin therapy, a substantial residual risk remains, highlighting the need for novel therapies. Thiazolidinediones (TZDs) are activators of the peroxisome proliferator-activated receptor-gamma that have multiple potentially beneficial effects on established and emerging metabolic risk factors. Available evidence suggests that, even in the presence of statin therapy, TZDs can improve risk factor profiles, reduce atherosclerosis and have a beneficial effect on cardiovascular outcomes. This article reviews the evidence supporting the use of therapy combining a TZD with a statin in patients with type 2 diabetes.