Indeed, pioglitazone-induced heart failure (HF) and the withdrawal of rosiglitazone because of cardiovascular concerns eventually led to a change in the policy of regulatory authorities.9,10 The US Food and Drug Administration and the European Medicines Agency now require all new antidiabetic drugs to undergo large cardiovascular outcome trials (CVOTs) to confirm cardiovascular safety and benefits
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The list of candidate signals will no doubt expand further, and a variety of non-peptide transmitters exist which have not been discussed, but which are strongly associated with these processes
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