The Effects of Pioglitazone in Reducing Atherosclerosis Progression and Neointima Volume in Type 2 Diabetic Patients: Prospective Randomized Study With Volumetric Intravascular Ultrasonography Analysis.
10.4070/kcj.2010.40.12.625
- Author:
Sung Hye YOU
1
;
Beum Suk KIM
;
Soon Jun HONG
;
Chul Min AHN
;
Do Sun LIM
Author Information
1. Department of Cardiology, Cardiovascular Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea. dslmd@kumc.or.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Intravascular ultrasonography;
Pioglitazone;
Diabetes mellitus;
Neointima
- MeSH:
Adiponectin;
Atherosclerosis;
Coronary Stenosis;
Diabetes Mellitus;
Follow-Up Studies;
Glycosaminoglycans;
Humans;
Inflammation;
Insulin Resistance;
Interleukin-6;
Neointima;
Prospective Studies;
Stents;
Thiazolidinediones;
Tumor Necrosis Factor-alpha;
Ultrasonography, Interventional;
Vitamin A
- From:Korean Circulation Journal
2010;40(12):625-631
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Pioglitazone has been known for its anti-atherogenic effects. We compared the effects of pioglitazone in reducing atherosclerosis progression and neointima volume in type 2 diabetic patients. SUBJECTS AND METHODS: This was a prospective, randomized single-blinded, 8-month follow-up study. Patients with significant coronary artery stenosis were randomly assigned to either pioglitazone (n=19) or placebo (n=18) following zotarolimus-eluting stent (ZES) implantation. Intravascular ultrasonography of the culprit vessel was performed from 20 mm distal and proximal to the stent at baseline. and at 8-month, and volumetric analysis was performed. Changes in inflammation markers, insulin resistance and lipid profile were compared. RESULTS: Changes in atherosclerosis progression from baseline in the pioglitazone group was significantly lower than that of the placebo group (0.06+/-0.73 vs. 1.16+/-1.41 mm3/mm, p=0.024, respectively), and neointima volume was significantly lower in the pioglitazone group compared to the placebo group (1.74+/-0.93 vs. 2.42+/-1.98 mm3/mm, p=0.007, respectively). Homeostatic model assessment-index, interleukin-6, and tumor necrosis factor-alpha levels were significantly lower in the pioglitazone group at 8 months. Adiponectin levels increased significantly only in the pioglitazone group. No significant differences in retinol binding protein-4 levels between the 2 groups were seen during the 8-month follow-up period. CONCLUSION: Compared to placebo, pioglitazone was associated with significant reduction in atherosclerosis progression and neointima formation in type 2 diabetic patients with ZES implantation.
