Takeda Pharmaceutical‘s diabetes drug Actos causes as many heart problems as GlaxoSmithKline’s (GSK) troubled Avandia medication, according to a study carried out by the American Heart Association.

Patients taking either Avandia or Actos were found to be 4% more likely to experience heart attacks, heart failure or die, the association said.

Actos became market leader in the aftermath of a 2007 study that showed Avandia-users had a 43% higher chance of heart attacks. This study, the first to compare the two medications, suggests that the risks are linked to this particular category of medicine.

The study involved more than 36,000 diabetes patients. Among them, 602 who took Avandia and 599 who took Actos suffered a heart attack, heart failure, both or died.