Health experts have claimed diabetes drug Actos would be a 'sensible alternative' to one which was banned last year.
Avandia (rosiglitazone) was banned by authorities in Europe, but can still be used in the US and Canada.
Patients who were given Actos suffered fewer heart problems, according to a study published on the BMJ website.
Meanwhile the drug was described as a very effective treatment by Diabetes UK.
Actos (rosiglitazone and pioglitazone) is designed to control blood sugar levels in patients with type 2 diabetes.
Scientists at the University of East Anglia examined 16 studies of more than 800,000 patients to compare the risks associated with each drug.
Rosiglitazone caused a 16% increase in the the risk of heart attack, a 23% rise for heart failure, and a 14% rise in the risk of death, when compared with pioglitazone.
The report says: "For patients who need thiazolidinedione treatment, continued use of rosiglitazone may lead to excess heart attacks, heart failure and mortality, compared with pioglitazone, the effect on public health may be considerable."