Avandia, the popular anti-Type II diabetes drug, increases heart attack risk by 43% -- and increases risk of death from heart disease by 64%, says a new study.

However, the overall risk was small. Among the 15,560 Avandia patients there were 86 heart attacks and 39 deaths, compared with 72 heart attacks and 22 deaths among the 12,283 patients not taking Avandia.

The new warning comes from an analysis of publicly available, short-term clinical studies comparing Avandia to other diabetes treatments. It shows that.

"In susceptible patients, [Avandia] therapy may be capable of provoking myocardial infarction [heart attack] or death from cardiovascular causes after relatively short-term exposure," suggest study investigators Steven Nissen and Kathy Wolski. Nissen chairs the Cleveland Clinic's department of cardiovascular medicine; he is past president of the American College of Cardiology.

Avandia is sold by itself and, as Avandamet and Avandaryl, in pills that combine Avandia with other diabetes medications. The findings do not appear to immediately affect Actos (made by Takeda Pharmaceuticals), a diabetes drug in the same class as Avandia.

The Food and Drug Administration (FDA) in 1999 approved Avandia on the basis of clinical trials showing that the drug could reduce blood-sugar levels in people with type 2 diabetes. Diabetes has been linked to both microvascular problems (problems of tiny blood vessels) such as blindness, kidney failure, and loss of circulation in the extremities. It has also been linked to heart disease.

But none of the trials on which Avandia was approved showed that the drug actually prevented the greatest threats to people with diabetes: microvascular problems, heart disease, or heart death.

In a strongly worded editorial accompanying the study, University of Washington researcher Bruce M. Psaty says the Nissen study means there's no good reason for
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